Healthcare Provider Details

I. General information

NPI: 1376604330
Provider Name (Legal Business Name): JUDITH ANDREWS BITTNER RN BSN CNOR RNFA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/13/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2625 E HURLEY POND RD
WALL TOWNSHIP NJ
07719-9776
US

IV. Provider business mailing address

2625 E HURLEY POND RD
WALL TOWNSHIP NJ
07719-9776
US

V. Phone/Fax

Practice location:
  • Phone: 732-280-1755
  • Fax:
Mailing address:
  • Phone: 732-280-1755
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WR0006X
TaxonomyRegistered Nurse First Assistant
License Number26NR05872800
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: