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General NPI Number Information
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NPI Number | 1205744323
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Entity Type | Individual
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Provider Name | MARYERLL SOCORRO TEVES APN
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Gender | Female
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Dates
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Enumeration Date | 08/31/2026
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Last Update Date | 08/31/2026
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Provider Practice Location Address
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Address Line | 99 BEAUVOIR AVE
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City | SUMMIT
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State | NJ
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Zip | 07901-3533
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Country | US
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Telephone | 908-522-2929
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Fax |
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Provider Business Mailing Address
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Address Line | 87 ADAMS ST
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City | ISELIN
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State | NJ
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Zip | 08830-1343
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Country | US
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Telephone | 917-345-2682
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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 | 26NJ15642100
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License Number State | NJ
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