Healthcare Provider Details

I. General information

NPI: 1033041173
Provider Name (Legal Business Name): OKSANA NAZAROV APN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/02/2026
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

402 COLTS NECK RD
FARMINGDALE NJ
07727-3642
US

IV. Provider business mailing address

331 NEWMAN SPRINGS RD STE 220
RED BANK NJ
07701-5792
US

V. Phone/Fax

Practice location:
  • Phone: 848-308-4615
  • Fax: 848-245-8930
Mailing address:
  • Phone: 732-807-0877
  • Fax: 201-751-1680

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number26NJ15538500
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: