Healthcare Provider Details

I. General information

NPI: 1891946174
Provider Name (Legal Business Name): ANNE TYNO RN APN, C.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/06/2008
Last Update Date: 03/29/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

195 LITTLE ALBANY ST
NEW BRUNSWICK NJ
08901-1914
US

IV. Provider business mailing address

66 W GILBERT ST 2ND FLOOR
TINTON FALLS NJ
07701-4947
US

V. Phone/Fax

Practice location:
  • Phone: 732-235-6777
  • Fax: 732-418-8221
Mailing address:
  • Phone: 732-212-0051
  • Fax: 732-212-0713

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WX0200X
TaxonomyOncology Registered Nurse
License Number26NN09328700
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: