Healthcare Provider Details

I. General information

NPI: 1265091292
Provider Name (Legal Business Name): EVA SPINGARN MSN RN CPNP-AC CCRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2019
Last Update Date: 06/12/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2406 PRIVET WAY
BASKING RIDGE NJ
07920-3135
US

IV. Provider business mailing address

2406 PRIVET WAY
BASKING RIDGE NJ
07920-3135
US

V. Phone/Fax

Practice location:
  • Phone: 908-256-5551
  • Fax:
Mailing address:
  • Phone: 908-256-5551
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0222X
TaxonomyCritical Care Pediatric Nurse Practitioner
License Number26NJ00859900
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code363LP0222X
TaxonomyCritical Care Pediatric Nurse Practitioner
License Number382923
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: