Healthcare Provider Details

I. General information

NPI: 1689062952
Provider Name (Legal Business Name): LADAN ABBASI NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/08/2015
Last Update Date: 01/08/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1738 ROUTE 31 NORTH, VEIN INSTITUTE OF HUNTERDON
CLINTON NJ
08809
US

IV. Provider business mailing address

133 AUTUMN RIDGE RD
BEDMINSTER NJ
07921
US

V. Phone/Fax

Practice location:
  • Phone: 908-788-0066
  • Fax: 908-735-2317
Mailing address:
  • Phone: 908-420-9330
  • Fax: 908-326-6147

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number2NJ00544600
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number2NJ00544600
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: