Individual
MS. MARY JACQUELINE NICOSIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.N. APN-C
Contact information
Practice address
211 SHREWSBURY AVE, RED BANK, NJ 07701-1250
(732) 212-8442
(732) 212-9030
Mailing address
126 MANOR DR, RED BANK, NJ 07701-2461
(732) 687-5321
(732) 212-9030
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
26NO06130700
NY
Other
Enumeration date
01/22/2007
Last updated
07/08/2007
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