Healthcare Provider Details

I. General information

NPI: 1275240384
Provider Name (Legal Business Name): MARGARET MARY ANGELIQUE CROFFORD CONSTABLE I DNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/31/2022
Last Update Date: 10/23/2025
Certification Date: 10/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1520 US HIGHWAY 130 STE 202
NORTH BRUNSWICK NJ
08902-3145
US

IV. Provider business mailing address

1520 US HIGHWAY 130 STE 202
NORTH BRUNSWICK NJ
08902-3145
US

V. Phone/Fax

Practice location:
  • Phone: 609-890-1050
  • Fax: 609-890-0950
Mailing address:
  • Phone: 609-890-1050
  • Fax: 609-890-0950

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number26NJ01302800
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: