Healthcare Provider Details

I. General information

NPI: 1992500540
Provider Name (Legal Business Name): ERIN ELIZABETH CIVITELLO FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/18/2025
Last Update Date: 04/14/2025
Certification Date: 04/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 BRANFORD DR
ROBBINSVILLE NJ
08691-3061
US

IV. Provider business mailing address

20 BRANFORD DR
ROBBINSVILLE NJ
08691-3061
US

V. Phone/Fax

Practice location:
  • Phone: 973-303-6897
  • Fax:
Mailing address:
  • Phone: 973-303-6897
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number26NJ15138400
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: