Healthcare Provider Details

I. General information

NPI: 1922789874
Provider Name (Legal Business Name): MONICA BEDRONI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/25/2023
Last Update Date: 01/02/2024
Certification Date: 10/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

54 GEORGE ST
AVENEL NJ
07001-1735
US

IV. Provider business mailing address

54 GEORGE ST
AVENEL NJ
07001-1735
US

V. Phone/Fax

Practice location:
  • Phone: 732-781-5763
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LN0005X
TaxonomyCritical Care Neonatal Nurse Practitioner
License Number26NJ14941900
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code163WN0002X
TaxonomyNeonatal Intensive Care Registered Nurse
License Number26NR16317400
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: