Healthcare Provider Details

I. General information

NPI: 1023416898
Provider Name (Legal Business Name): MICHELLE GILES-HONORE APN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/10/2014
Last Update Date: 06/24/2025
Certification Date: 06/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28 VALLEY RD # 148
MONTCLAIR NJ
07042-2709
US

IV. Provider business mailing address

90 WASHINGTON ST # 305
EAST ORANGE NJ
07017-1050
US

V. Phone/Fax

Practice location:
  • Phone: 973-559-4600
  • Fax: 855-998-4358
Mailing address:
  • Phone: 973-676-2492
  • Fax: 973-676-5901

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number26NJ00523400
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: