Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | 26NJ00119000 | NJ |
NPI | 1003985961 |
---|---|
Provider Name | Ms. Sandra A Moharsky-Cahn |
First Address | Neptune, NJ 07753-5888 |
Second Address | Asbury Park, NJ 07712-5359 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/11/2006 |
Last Update Date | 06/04/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
22-3471515 | TAX ID (01) | NJ |