Healthcare Provider Details

I. General information

NPI: 1235127309
Provider Name (Legal Business Name): MONIQUE CIMORELLI N.P
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/12/2005
Last Update Date: 05/12/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

680 BLAIR MILL RD
HORSHAM PA
19044-2223
US

IV. Provider business mailing address

125 E FRANKLIN AVE
EDGEWATER PARK NJ
08010-1846
US

V. Phone/Fax

Practice location:
  • Phone: 866-297-9232
  • Fax: 888-816-8109
Mailing address:
  • Phone: 609-605-8035
  • Fax: 609-526-5799

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number26NN10761400
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: