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NPI Code Detail

MEDICARE: MRS. RENEE BOLOGNESE APN

MEDICARE: MRS. RENEE BOLOGNESE 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
1363LN0000XNeonatal Nurse Practitioner26NN07235200NJ

General Provider Information

NPI Number : 1932285376
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. RENEE BOLOGNESE APN
Provider Business Mailing Address
First Line : 36 CAPSTAN RD
Second Line :
City : WARETOWN
State : NJ
Zip : 08758-1619
Country : US
Telephone Number : 609-693-6015
Fax Number :
Provider Business Practice Location Address
First Line : 255 3RD AVE
Second Line :
City : LONG BRANCH
State : NJ
Zip : 07740-6214
Country : US
Telephone Number : 732-222-7006
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/28/2006
Last Update Date : 07/08/2007

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