Healthcare Provider Details

I. General information

NPI: 1871479790
Provider Name (Legal Business Name): LATOYA CELESTINE APN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/14/2025
Last Update Date: 06/05/2026
Certification Date: 06/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 BROAD ST STE 606
NEWARK NJ
07102-4537
US

IV. Provider business mailing address

134 KRONE PL
HACKENSACK NJ
07601-3811
US

V. Phone/Fax

Practice location:
  • Phone: 201-822-1161
  • Fax:
Mailing address:
  • Phone: 201-450-3447
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number26NJ15337000
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: