Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | 26NNO6837100 | NJ |
NPI | 1013080282 |
---|---|
Provider Name | Ms. Eileen Cieri |
First Address | West Long Branch, NJ 07764-1318 |
Second Address | Wall Township, NJ 07719-3512 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/11/2006 |
Last Update Date | 16/12/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
S67895 | (02) | NJ |