=====================================================
General NPI Number Information
=====================================================
NPI Number | 1790592624
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | CLARE KIRALY APN
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/13/2024
-----------------------------------------------------
Last Update Date | 01/27/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 140 PARK AVE
-----------------------------------------------------
City | FLORHAM PARK
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07932-1049
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 908-273-4300
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 15 CENTER AVE APT 1
-----------------------------------------------------
City | MORRISTOWN
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07960-9340
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 908-370-1010
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | 26NJ15203000
-----------------------------------------------------
License Number State | NJ
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 363L00000X
-----------------------------------------------------
Taxonomy Name | Nurse Practitioner
-----------------------------------------------------
License Number | 26NJ15203000
-----------------------------------------------------
License Number State | NJ
-----------------------------------------------------