MEDICARE: MICHELLE NASSERY

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	363LF0000X	Family Nurse Practitioner	26NJ15530200	NJ

General Provider Information

NPI Number	:	1760200612
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHELLE NASSERY

Provider Business Mailing Address
First Line	:	415 WASHINGTON ST
Second Line	:
City	:	HOBOKEN
State	:	NJ
Zip	:	07030-4870
Country	:	US
Telephone Number	:	646-346-8809
Fax Number	:

Provider Business Practice Location Address
First Line	:	415 WASHINGTON ST
Second Line	:
City	:	HOBOKEN
State	:	NJ
Zip	:	07030-4870
Country	:	US
Telephone Number	:	646-346-8809
Fax Number	:

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

Provider Enumeration Date	:	09/30/2024
Last Update Date	:	02/21/2026

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Directions to “ MICHELLE NASSERY ” Practice Location

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