Provider Demographics
NPI:1003407776
Name:SANACORE, DEANNA MARIE (APN)
Entity Type:Individual
Prefix:MRS
First Name:DEANNA
Middle Name:MARIE
Last Name:SANACORE
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38 TUXEDO DR
Mailing Address - Street 2:
Mailing Address - City:WAYNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07470-2728
Mailing Address - Country:US
Mailing Address - Phone:862-591-0454
Mailing Address - Fax:
Practice Address - Street 1:342 HAMBURG TPKE STE 107
Practice Address - Street 2:
Practice Address - City:WAYNE
Practice Address - State:NJ
Practice Address - Zip Code:07470-2166
Practice Address - Country:US
Practice Address - Phone:973-870-0777
Practice Address - Fax:888-465-2135
Is Sole Proprietor?:No
Enumeration Date:2021-01-26
Last Update Date:2023-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ01107400363LG0600X, 363LA2200X, 363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care