Healthcare Provider Details

I. General information

NPI: 1568993806
Provider Name (Legal Business Name): TERESA MARTONE APN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2017
Last Update Date: 01/24/2024
Certification Date: 01/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8025 BLACK HORSE PIKE STE 501
PLEASANTVILLE NJ
08232-2967
US

IV. Provider business mailing address

8025 BLACK HORSE PIKE STE 501
PLEASANTVILLE NJ
08232-2967
US

V. Phone/Fax

Practice location:
  • Phone: 609-464-1135
  • Fax:
Mailing address:
  • Phone: 609-464-1135
  • Fax: 856-228-7252

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number26NJ00727200
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: