=====================================================
General NPI Number Information
=====================================================
NPI Number | 1922762426
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ELAINE QUAYE MSN, APN, PMHNP-BC
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/29/2021
-----------------------------------------------------
Last Update Date | 10/08/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 550 MAYOR GIBSON BLVD STE 606
-----------------------------------------------------
City | NEWARK
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07102-4537
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 201-822-1161
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1555 MUNN AVE
-----------------------------------------------------
City | HILLSIDE
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07205-1647
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 862-218-4492
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LP0808X
-----------------------------------------------------
Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
-----------------------------------------------------
License Number | 26NJ01290300
-----------------------------------------------------
License Number State | NJ
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 163WP0808X
-----------------------------------------------------
Taxonomy Name | Psychiatric/Mental Health Registered Nurse
-----------------------------------------------------
License Number | 26NR20673700
-----------------------------------------------------
License Number State | NJ
-----------------------------------------------------