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General NPI Number Information
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NPI Number | 1023357605
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Entity Type | Individual
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Provider Name | ATHENA THERESA BAGAIPO FNP-C
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Gender | Female
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Dates
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Enumeration Date | 02/02/2013
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Last Update Date | 05/06/2014
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Provider Practice Location Address
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Address Line | 290 RED SCHOOL LN
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City | PHILLIPSBURG
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State | NJ
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Zip | 08865-2276
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Country | US
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Telephone | 908-246-7060
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Fax | 610-335-4404
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Provider Business Mailing Address
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Address Line | 617 ALMOND CT
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City | FLEMINGTON
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State | NJ
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Zip | 08822-3141
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Country | US
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Telephone | 908-968-3030
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 26NJ00442900
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 33 336397
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License Number State | NY
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