MEDICARE: PAIGE DEVECKA PMHNP BC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	26NJ15552000	NJ

General Provider Information

NPI Number	:	1124960661
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAIGE DEVECKA PMHNP BC

Provider Business Mailing Address
First Line	:	40 BEY LEA RD
Second Line	:
City	:	TOMS RIVER
State	:	NJ
Zip	:	08753-2989
Country	:	US
Telephone Number	:	732-831-6094
Fax Number	:	732-832-3632

Provider Business Practice Location Address
First Line	:	40 BEY LEA RD
Second Line	:
City	:	TOMS RIVER
State	:	NJ
Zip	:	08753-2989
Country	:	US
Telephone Number	:	732-831-6094
Fax Number	:	732-832-3632

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/06/2026
Last Update Date	:	04/06/2026

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