MEDICARE: OXANA DANYSHEVA 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
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	26NJ15524500	NJ

General Provider Information

NPI Number	:	1538013610
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	OXANA DANYSHEVA APN

Provider Business Mailing Address
First Line	:	2185 LEMOINE AVE STE 1H
Second Line	:
City	:	FORT LEE
State	:	NJ
Zip	:	07024-6030
Country	:	US
Telephone Number	:	888-701-6472
Fax Number	:	800-309-6903

Provider Business Practice Location Address
First Line	:	2185 LEMOINE AVE STE 1H
Second Line	:
City	:	FORT LEE
State	:	NJ
Zip	:	07024-6030
Country	:	US
Telephone Number	:	877-959-8180
Fax Number	:

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

Provider Enumeration Date	:	02/24/2026
Last Update Date	:	03/03/2026

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