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NPI Code Detail

MEDICARE: MRS. CELINA JANNICELLI FNP

MEDICARE: MRS. CELINA JANNICELLI FNP
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 Practitioner26NJ00328200NJ

General Provider Information

NPI Number : 1568750156
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. CELINA JANNICELLI FNP
Provider Business Mailing Address
First Line : PO BOX 2269
Second Line :
City : POCONO PINES
State : PA
Zip : 18350-2269
Country : US
Telephone Number : 973-979-5860
Fax Number :
Provider Business Practice Location Address
First Line : 156 NEWARK POMPTON TPKE
Second Line :
City : PEQUANNOCK
State : NJ
Zip : 07440-1327
Country : US
Telephone Number : 973-692-1221
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/15/2011
Last Update Date : 02/25/2013

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