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NPI Code Detail

MEDICARE: MARIANNE ELIZABETH CAVANAUGH APN

MEDICARE: MARIANNE ELIZABETH CAVANAUGH 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
1363LA2100XAcute Care Nurse Practitioner26NJ00874200NJ
2364SC0200XCritical Care Medicine Clinical Nurse Specialist26NJ00874200NJ

General Provider Information

NPI Number : 1821568817
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARIANNE ELIZABETH CAVANAUGH APN
Provider Business Mailing Address
First Line : 224 HAMBURG TPKE
Second Line :
City : WAYNE
State : NJ
Zip : 07470-2168
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 224 HAMBURG TPKE
Second Line :
City : WAYNE
State : NJ
Zip : 07470-2168
Country : US
Telephone Number : 973-754-2476
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/03/2018
Last Update Date : 04/04/2019

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