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General NPI Number Information
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NPI Number | 1417092875
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Entity Type | Individual
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Provider Name | GERTI ELISABETH HEIDER PHD, APRN, BC
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Gender | Female
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Dates
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Enumeration Date | 02/21/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 505 RAMAPO VALLEY RD
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City | MAHWAH
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State | NJ
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Zip | 07430-1623
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Country | US
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Telephone | 201-684-7206
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Fax | 201-684-7954
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Provider Business Mailing Address
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Address Line | 1259 GREEN POND RD
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City | NEWFOUNDLAND
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State | NJ
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Zip | 07435-1215
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Country | US
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Telephone | 973-697-9283
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Fax | 973-208-1988
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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 | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | 26NN06741100
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License Number State | NJ
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