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General NPI Number Information
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NPI Number | 1295498251
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Entity Type | Individual
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Provider Name | ANEL IVETH MARQUEZ AGPCNP-BC
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Gender | Female
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Dates
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Enumeration Date | 10/18/2021
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Last Update Date | 10/18/2021
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Provider Practice Location Address
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Address Line | 205 BROWERTOWN RD STE 205
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City | WOODLAND PARK
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State | NJ
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Zip | 07424-2610
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Country | US
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Telephone | 973-569-6112
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Fax | 973-837-6780
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Provider Business Mailing Address
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Address Line | 94 SPENCER AVE
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City | CLIFTON
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State | NJ
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Zip | 07013-2831
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Country | US
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Telephone | 973-704-0685
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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 | 26NJ01210100
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License Number State | NJ
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