Individual
ERISA MASKA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
256 MORNINGSIDE AVE FL 2, CLIFFSIDE PARK, NJ 07010-1407
(347) 654-7783
Mailing address
331 NEWMAN SPRINGS RD STE 220, RED BANK, NJ 07701-5792
(732) 807-0877
(201) 751-1680
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
26NJ15185000
NJ
Other
Enumeration date
01/03/2025
Last updated
03/18/2025
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