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General NPI Number Information
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NPI Number | 1659902831
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Entity Type | Individual
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Provider Name | KIMBERLY COLANGELO PMHNP
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Gender | Female
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Dates
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Enumeration Date | 01/28/2020
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Last Update Date | 07/17/2024
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Provider Practice Location Address
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Address Line | 1550 PARK AVE STE 102
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City | SOUTH PLAINFIELD
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State | NJ
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Zip | 07080-5565
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Country | US
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Telephone | 609-890-1050
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Fax | 609-890-0950
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Provider Business Mailing Address
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Address Line | 1550 PARK AVE STE 102
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City | SOUTH PLAINFIELD
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State | NJ
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Zip | 07080-5565
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Country | US
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Telephone | 609-594-5827
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 402906
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 26NJ01408300
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License Number State | NJ
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