Healthcare Provider Details

I. General information

NPI: 1043346448
Provider Name (Legal Business Name): MAUREEN TERESE AMBINDER APRN BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MAUREEN TERESE AMBINDER-KNICE

II. Dates (important events)

Enumeration Date: 02/27/2007
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21 ANCHOR BAY CT
BLUFFTON SC
29910-9573
US

IV. Provider business mailing address

21 ANCHOR BAY CT
BLUFFTON SC
29910-9573
US

V. Phone/Fax

Practice location:
  • Phone: 973-547-1861
  • Fax: 856-249-9708
Mailing address:
  • Phone: 973-547-1861
  • Fax: 856-249-9708

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number26NJ00117300
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: