Healthcare Provider Details

I. General information

NPI: 1700566205
Provider Name (Legal Business Name): ANGELA MARIE MAIORANO APN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/19/2023
Last Update Date: 07/19/2023
Certification Date: 07/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 GARDEN STATE PLZ
PARAMUS NJ
07652
US

IV. Provider business mailing address

57 TIMBERHILL DR
EAST HANOVER NJ
07936-3314
US

V. Phone/Fax

Practice location:
  • Phone: 973-943-6196
  • Fax:
Mailing address:
  • Phone: 973-943-6196
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number26NJ14877200
License Number StateNJ

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: