Healthcare Provider Details

I. General information

NPI: 1497121552
Provider Name (Legal Business Name): AMY TOWNSEND RIORDAN APN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/12/2015
Last Update Date: 02/09/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5401 HARDING HWY SUITE 3
MAYS LANDING NJ
08330-2243
US

IV. Provider business mailing address

5401 HARDING HWY SUITE 3
MAYS LANDING NJ
08330-2243
US

V. Phone/Fax

Practice location:
  • Phone: 609-365-6217
  • Fax: 609-653-1439
Mailing address:
  • Phone: 609-365-6217
  • Fax: 609-653-1439

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number26NJ0013000
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: