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Individual

JANINE DEFEO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CPNP

Contact information

Practice address
150 NEW PROVIDENCE RD, MOUNTAINSIDE, NJ 07092-2590
(908) 301-5570
(908) 301-5456
Mailing address
150 NEW PROVIDENCE RD, MOUNTAINSIDE, NJ 07092-2590
(908) 301-5570
(908) 301-5456

Taxonomy

Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
26NJ00028600
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
185972
AMERIGROUP
NJ
01
221487148-027
QUALCARE
NJ
01
2K3679
HEALTHNET
NJ
01
7353830
CIGNA HEALTHCARE
NJ
01
P2948380
OXFORD HEALTH PLANS
NJ
01
S51B01
EMPIRE
NJ
Enumeration date
02/23/2006
Last updated
07/08/2007
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