Healthcare Provider Details

I. General information

NPI: 1679810204
Provider Name (Legal Business Name): ADVANCED PRACTICE SPECIALIST
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/16/2013
Last Update Date: 01/16/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29 MEADOW LN
EAST WINDSOR NJ
08520-2121
US

IV. Provider business mailing address

PO BOX 502
STILWELL KS
66085-0502
US

V. Phone/Fax

Practice location:
  • Phone: 609-858-9918
  • Fax:
Mailing address:
  • Phone: 713-344-2400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: PATRICIA SAVERIANO
Title or Position: OWNER
Credential:
Phone: 609-858-9918