Individual
SUSAN A ANGELICOLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSN, RNC
Contact information
Practice address
890 MOUNTAIN AVE, NEW PROVIDENCE, NJ 07974-1218
(908) 277-8799
(908) 608-2376
Mailing address
66 W GILBERT ST, 2ND FLOOR, TINTON FALLS, NJ 07701-4947
(732) 212-0051
(732) 212-0713
Taxonomy
Speciality
Code
Description
License number
State
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
Primary
26NN11336200
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0052027
—
NJ
Enumeration date
12/13/2006
Last updated
07/05/2019
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