Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LW0102X | Nurse Practitioner - Women's Health | NO06391700 | NJ |
NPI | 1053423418 |
---|---|
Provider Name | Ms. Patricia Ann Anselmo |
First Address | East Brunswick, NJ 08816-4098 |
Second Address | East Brunswick, NJ 08816-4098 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2006 |
Last Update Date | 05/08/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
22-1487330-255 | QUAL CARE (01) | NJ |
2660356 | CIGNA (01) | NJ |