Individual
NICOLE MARINA BANCROFT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHYSICIAN ASSISTANT
Contact information
Practice address
305 N RTE 17 STE 3-100A, PARAMUS, NJ 07652-2913
(201) 470-5853
Mailing address
3 BUCKEYE LN, FLEMINGTON, NJ 08822-2654
(908) 963-7007
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
25MP00856900
NJ
363AS0400X
Surgical Physician Assistant
Primary
25MP00856900
NJ
Other
Enumeration date
08/02/2024
Last updated
07/16/2025
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