Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0200X | Nurse Practitioner - Pediatrics | 26NJ00585100 | NJ |
NPI | 1033587035 |
---|---|
Provider Name | Mrs. Amy Suzanne Coyle |
First Address | Ocean Township, NJ 07712 |
Second Address | Ocean Township, NJ 07712 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/09/2015 |
Last Update Date | 08/09/2015 |