Healthcare Provider Details

I. General information

NPI: 1275522658
Provider Name (Legal Business Name): CATHLEEN ANNE DUFFY M.S.N., A.P.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 10/18/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 CANDLEWOOD COMMONS
HOWELL NJ
07731-2170
US

IV. Provider business mailing address

75 RED VALLEY RD
CLARKSBURG NJ
08510-1402
US

V. Phone/Fax

Practice location:
  • Phone: 732-370-9600
  • Fax: 732-370-9656
Mailing address:
  • Phone: 609-259-5539
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number26NN07033300
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: