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General NPI Number Information
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NPI Number | 1043023716
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Entity Type | Individual
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Provider Name | SUSANA PEREIRA APN
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Gender | Female
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Dates
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Enumeration Date | 01/28/2025
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Last Update Date | 01/28/2025
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Provider Practice Location Address
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Address Line | 36 NEWARK AVE
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City | BELLEVILLE
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State | NJ
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Zip | 07109-4119
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Country | US
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Telephone | 973-759-6896
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Fax |
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Provider Business Mailing Address
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Address Line | 433 MANOR AVE
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City | CRANFORD
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State | NJ
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Zip | 07016-2063
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Country | US
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Telephone | 908-759-5992
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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 | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | 26NJ15264300
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License Number State | NJ
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