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Provider Information for 1750712154

Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know


Gender: FEMALE

Individual NPI: 1750712154

Calendar   Last Updated:  2020-05-27
  Certification Date:  2020-05-27


Name Value
NPI 1750712154
Enumeration Date 2013-12-10
NPI Type 1 - Individual
Sole Proprietor YES
Status Active
Mailing Address PO BOX 416457
BOSTON, MA 02241-6457
United States

Phone: 844-362-1735 | Fax:
View Map External Link
Primary Practice Address 435 SOUTH ST STE 340
MORRISTOWN, NJ 07960-6473
United States

Phone: 973-971-5524 | Fax:
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
Primary Taxonomy Selected Taxonomy State License Number
Yes 363LF0000X - Nurse Practitioner Family NJ 26NJ00477600