Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0200X | Nurse Practitioner - Pediatrics | 26NJ00454400 | NJ |
NPI | 1033548748 |
---|---|
Provider Name | Annamarie Nass |
First Address | Ringoes, NJ 08551-1401 |
Second Address | Secaucus, NJ 07094-2921 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/11/2013 |
Last Update Date | 03/11/2013 |