Healthcare Provider Details

I. General information

NPI: 1659849081
Provider Name (Legal Business Name): CHRISTINE MARIE MEO APN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/03/2018
Last Update Date: 11/03/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

865 STONE ST
RAHWAY NJ
07065-2742
US

IV. Provider business mailing address

84 IDOLSTONE LN
ABERDEEN NJ
07747-1760
US

V. Phone/Fax

Practice location:
  • Phone: 732-680-7911
  • Fax:
Mailing address:
  • Phone: 908-216-4846
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number26NJ00830200
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: