Individual
ELLEN VANDERSTAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
137 MAIN RD, SUITE 200, MONTVILLE, NJ 07045-9231
(973) 402-0025
(973) 402-0508
Mailing address
137 MAIN RD, STE 200, MONTVILLE, NJ 07045-9231
(973) 703-0018
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
26NJ00588600
NJ
Other
Enumeration date
09/13/2015
Last updated
05/05/2016
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