Healthcare Provider Details

I. General information

NPI: 1124263918
Provider Name (Legal Business Name): PATRICIA MOLINELLI NP, APRN, BC, AOCNS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/08/2008
Last Update Date: 12/08/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

80 WEST END AVENUE
SOMERVILLE NJ
08876
US

IV. Provider business mailing address

396 WINCHESTER AVE
STATEN ISLAND NY
10312-5109
US

V. Phone/Fax

Practice location:
  • Phone: 908-704-8088
  • Fax:
Mailing address:
  • Phone: 973-256-2568
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number304487
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code364SX0200X
TaxonomyOncology Clinical Nurse Specialist
License Number26NJ00165800
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: