Provider Demographics
NPI:1013410810
Name:CAMMARATA, RACHANA U (ANP)
Entity Type:Individual
Prefix:
First Name:RACHANA
Middle Name:U
Last Name:CAMMARATA
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:425 WESTERN BLVD
Mailing Address - Street 2:
Mailing Address - City:BAYVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08721-3313
Mailing Address - Country:US
Mailing Address - Phone:732-674-5048
Mailing Address - Fax:
Practice Address - Street 1:2301 E EVESHAM RD STE 505
Practice Address - Street 2:
Practice Address - City:VOORHEES
Practice Address - State:NJ
Practice Address - Zip Code:08043-4506
Practice Address - Country:US
Practice Address - Phone:856-520-8718
Practice Address - Fax:856-520-8719
Is Sole Proprietor?:No
Enumeration Date:2018-03-18
Last Update Date:2023-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00809100363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily