Healthcare Provider Details

I. General information

NPI: 1174508188
Provider Name (Legal Business Name): MONIQUE SIMMONS-ROMANO DNP,, APN,C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/13/2005
Last Update Date: 07/19/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

131 MORRISTOWN RD
BASKING RIDGE NJ
07920-1654
US

IV. Provider business mailing address

131 MORRISTOWN RD
BASKING RIDGE NJ
07920-1654
US

V. Phone/Fax

Practice location:
  • Phone: 646-942-7206
  • Fax:
Mailing address:
  • Phone: 646-942-7206
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberNN104995
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: