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NPI Code Detail

MEDICARE: CARLA FONTANGE APN

MEDICARE:   CARLA  FONTANGE  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
1363L00000XNurse Practitioner26NJ15303800NJ

General Provider Information

NPI Number : 1578079695
Entity Type Code : Individual
Provider Name (Legal Business Name) : CARLA FONTANGE APN
Provider Business Mailing Address
First Line : 2810 MORRIS AVE
Second Line :
City : UNION
State : NJ
Zip : 07083-4850
Country : US
Telephone Number : 973-620-2370
Fax Number :
Provider Business Practice Location Address
First Line : 2810 MORRIS AVE
Second Line :
City : UNION
State : NJ
Zip : 07083-4850
Country : US
Telephone Number : 973-620-2370
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/27/2017
Last Update Date : 02/23/2026

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Directions to “ CARLA FONTANGE APN” Practice Location

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