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General NPI Number Information
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NPI Number | 1801624937
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Entity Type | Individual
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Provider Name | DANIELLE MOED
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Gender | Female
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Dates
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Enumeration Date | 07/22/2024
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Last Update Date | 10/06/2025
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Provider Practice Location Address
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Address Line | 65 BERGEN ST
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City | NEWARK
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State | NJ
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Zip | 07107-3001
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Country | US
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Telephone | 973-972-2513
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Fax |
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Provider Business Mailing Address
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Address Line | 13 FRANKLIN AVE
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City | CRANFORD
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State | NJ
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Zip | 07016-1941
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Country | US
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Telephone | 732-865-0154
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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 | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 26NJ15358100
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 163WC0200X
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Taxonomy Name | Critical Care Medicine Registered Nurse
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License Number | 26NR20102500
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License Number State | NJ
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