Organization
COUNTY OF BERGEN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEIDRA PARKS RN MSN CPNP, APN (ADVANCE PRACTICE NURSE)
(201) 336-3912
Entity
Organization
Contact information
Practice address
200 NORTH ST, TETERBORO, NJ 07608-1214
(201) 336-3912
(201) 336-3919
Mailing address
200 NORTH ST, TETERBORO, NJ 07608-1214
(201) 336-3912
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
—
NJ
Other
Enumeration date
02/01/2008
Last updated
07/27/2015
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