Healthcare Provider Details

I. General information

NPI: 1023931060
Provider Name (Legal Business Name): RHEA COREEN LE BLANC APN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/04/2026
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 CLARA MAASS DR
BELLEVILLE NJ
07109-3550
US

IV. Provider business mailing address

2322 CHURCH ST
RAHWAY NJ
07065-3630
US

V. Phone/Fax

Practice location:
  • Phone: 973-450-2156
  • Fax:
Mailing address:
  • Phone: 516-567-2994
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LC0200X
TaxonomyCritical Care Medicine Nurse Practitioner
License Number26NJ15620200
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: