Individual
DANIELLE LOUISE SEVASTAKIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
424 S MAIN ST, FORKED RIVER, NJ 08731-4654
(609) 971-3500
Mailing address
413 SHIP AVE, BEACHWOOD, NJ 08722-2630
(732) 575-4830
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
26NJ14957600
NJ
Other
Enumeration date
12/05/2023
Last updated
09/26/2024
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