Healthcare Provider Details

I. General information

NPI: 1295645125
Provider Name (Legal Business Name): SAGE ADVANCE PRACTICE HEALTHCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/11/2026
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 SCOTCH RD
EWING NJ
08628-2500
US

IV. Provider business mailing address

11 BRITTON CT
LAWRENCE NJ
08648-2608
US

V. Phone/Fax

Practice location:
  • Phone: 609-647-3324
  • Fax:
Mailing address:
  • Phone: 609-647-3324
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: GREGORIE ACCEUS
Title or Position: NURSE PRACTITIONER
Credential: APN
Phone: 609-647-3324