MEDICARE: EMILY ANN COFFEY FNP-BC

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	207Q00000X	Family Medicine Physician	26NJ14865000	NJ

General Provider Information

NPI Number	:	1407531825
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EMILY ANN COFFEY FNP-BC

Provider Business Mailing Address
First Line	:	27 PAVILICA RD
Second Line	:
City	:	STOCKTON
State	:	NJ
Zip	:	08559-1106
Country	:	US
Telephone Number	:	757-298-5110
Fax Number	:

Provider Business Practice Location Address
First Line	:	3535 US HIGHWAY 1 STE 463A
Second Line	:
City	:	PRINCETON
State	:	NJ
Zip	:	08540-5974
Country	:	US
Telephone Number	:	609-445-1200
Fax Number	:

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

Provider Enumeration Date	:	06/21/2023
Last Update Date	:	06/21/2023

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Directions to “ EMILY ANN COFFEY FNP-BC” Practice Location

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