Healthcare Provider Details

I. General information

NPI: 1396006862
Provider Name (Legal Business Name): JENOVEVA ORSINI A.P.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JENOVEVA ORSINI-NEGRONI

II. Dates (important events)

Enumeration Date: 05/31/2012
Last Update Date: 10/10/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3458 NEELY ROAD
MC GUIRE NJ
08641
US

IV. Provider business mailing address

3458 NEELY ROAD JB-MDL
MC GUIRE NJ
08641
US

V. Phone/Fax

Practice location:
  • Phone: 609-754-9107
  • Fax: 609-754-9195
Mailing address:
  • Phone: 609-754-9107
  • Fax: 973-926-8206

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number26NJ00380100
License Number StateNJ

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: