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NPI Code Detail

MEDICARE: AMANDA D RUTHERFORD APN

MEDICARE:   AMANDA D RUTHERFORD  APN
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
1363LF0000XFamily Nurse Practitioner26NJ00402600NJ

General Provider Information

NPI Number : 1275877474
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMANDA D RUTHERFORD APN
Provider Business Mailing Address
First Line : 85 CHESTNUT RIDGE RD
Second Line :
City : MONTVALE
State : NJ
Zip : 07645-1827
Country : US
Telephone Number : 201-930-1700
Fax Number :
Provider Business Practice Location Address
First Line : 85 CHESTNUT RIDGE RD
Second Line :
City : MONTVALE
State : NJ
Zip : 07645-1827
Country : US
Telephone Number : 201-930-1700
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/12/2012
Last Update Date : 03/13/2018

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Directions to “ AMANDA D RUTHERFORD APN” Practice Location

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