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Nurse Practitioner · West Orange, NJ

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At a glance

83 Old Short Hills Rd, West Orange, NJ 07052-1097

NPPES record updated Apr 23, 2024. Public records can lag behind changes at a practice.

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Practice location

83 Old Short Hills Rd
West Orange, NJ 07052-1097

Professional details: NPI, taxonomy & registry record

NPI1861247769

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Registry details

Primary taxonomy: Nurse Practitioner
Taxonomy code: 363L00000X
Enumeration date: Apr 23, 2024
Record updated: Apr 23, 2024

More registry details

Provider type: Organization · Type 2

Reported taxonomies and licenses

Nurse Practitioner

363L00000X · Primary

Specialty details in registry

363LA2200X

Specialty details in registry

363LG0600X

License numbers and credentials are reported to NPPES; HCPList does not independently verify them.

Practice location

83 Old Short Hills Rd
West Orange, NJ 07052-1097

Phone: (973) 752-7464

Mailing address

83 OLD SHORT HILLS RD

WEST ORANGE, NJ 070521097

Source: NPPES Source through Oct 18, 2026An NPI does not verify licensure or credentials.

Information may be outdated or incomplete. Confirm details directly with the practice. HCPList is an independent directory and is not affiliated with CMS.

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