Healthcare Provider Details

I. General information

NPI: 1437011145
Provider Name (Legal Business Name): REBECCA COONS APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/01/2025
Last Update Date: 12/01/2025
Certification Date: 12/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 LYONS AVE
NEWARK NJ
07112-2027
US

IV. Provider business mailing address

933 ROBIN CT
LEDGEWOOD NJ
07852-2622
US

V. Phone/Fax

Practice location:
  • Phone: 973-926-7000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number26NJ15478900
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: