Healthcare Provider Details

I. General information

NPI: 1922831635
Provider Name (Legal Business Name): SOFIA A ARENAS APN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/20/2024
Last Update Date: 11/22/2024
Certification Date: 11/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

177 MAIN ST
MATAWAN NJ
07747-4107
US

IV. Provider business mailing address

177 MAIN ST
MATAWAN NJ
07747-4107
US

V. Phone/Fax

Practice location:
  • Phone: 609-890-1050
  • Fax: 609-890-0950
Mailing address:
  • Phone: 609-890-1050
  • Fax: 609-890-0950

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number26NJ15116600
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: