MEDICARE: MAIA CYNTHIA GREENE APRN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	364SF0001X	Family Health Clinical Nurse Specialist	26NJ00329000	NJ
2	363L00000X	Nurse Practitioner	26NJ00329000	NJ

General Provider Information

NPI Number	:	1154533511
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MAIA CYNTHIA GREENE APRN

Provider Business Mailing Address
First Line	:	331 NEWMAN SPRINGS RD
Second Line	:	BLDG 2, STE 220
City	:	RED BANK
State	:	NJ
Zip	:	07701-5688
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	616 GROVE AVE
Second Line	:
City	:	EDISON
State	:	NJ
Zip	:	08820-3212
Country	:	US
Telephone Number	:	732-548-6303
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/05/2007
Last Update Date	:	12/12/2024

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Directions to “ MAIA CYNTHIA GREENE APRN” Practice Location

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