Healthcare Provider Details

I. General information

NPI: 1376207621
Provider Name (Legal Business Name): FE N TAYO APN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/23/2021
Last Update Date: 12/07/2021
Certification Date: 11/29/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8 RIMWOOD LN
HOWELL NJ
07731-1274
US

IV. Provider business mailing address

2102 CORLIES AVE
NEPTUNE CITY NJ
07753
US

V. Phone/Fax

Practice location:
  • Phone: 201-699-7488
  • Fax:
Mailing address:
  • Phone: 732-974-0100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number26NJ01220000
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: