Healthcare Provider Details

I. General information

NPI: 1508942269
Provider Name (Legal Business Name): NANCY BREY MSN, CNS.C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/27/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

450 SUMMIT AVE
HACKENSACK NJ
07601-1503
US

IV. Provider business mailing address

160 MYRTLE AVE
ALLENDALE NJ
07401-1518
US

V. Phone/Fax

Practice location:
  • Phone: 201-487-9104
  • Fax: 201-487-3903
Mailing address:
  • Phone: 201-390-0067
  • Fax: 201-487-3903

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number26NR04560800
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: