Healthcare Provider Details

I. General information

NPI: 1346881208
Provider Name (Legal Business Name): TRICIA ANN DESIDER PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/02/2019
Last Update Date: 03/27/2026
Certification Date: 03/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2911 NJ 88 SUITE 2
POINT PLEASANT NJ
08742
US

IV. Provider business mailing address

534 RIDGEVIEW CT
TOMS RIVER NJ
08753-2735
US

V. Phone/Fax

Practice location:
  • Phone: 732-295-1008
  • Fax:
Mailing address:
  • Phone: 848-287-3696
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number26NJ15457500
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code163WR0006X
TaxonomyRegistered Nurse First Assistant
License Number26NR14747500
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: