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General NPI Number Information
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NPI Number | 1750501706
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Entity Type | Individual
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Provider Name | DEBRA ANN NERETICH RN, APN
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Gender | Female
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Dates
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Enumeration Date | 05/01/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 94 OLD SHORT HILLS RD 1ST FLOOR EAST WING SUITE 182
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City | LIVINGSTON
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State | NJ
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Zip | 07039-5672
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Country | US
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Telephone | 973-322-8096
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Fax | 973-322-2856
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Provider Business Mailing Address
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Address Line | 69 GOODLUCK ST
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City | EDISON
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State | NJ
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Zip | 08820-2442
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Country | US
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Telephone | 973-322-8096
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Fax | 973-322-2856
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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 | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | 26NN09741000
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License Number State | NJ
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