Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | 26NJ01107400 | NJ |
NPI | 1003407776 |
---|---|
Provider Name | Mrs. Deanna Marie Sanacore |
First Address | Wayne, NJ 07470-2728 |
Second Address | Wayne, NJ 07470-2728 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/01/2021 |
Last Update Date | 05/02/2021 |