Provider Demographics
NPI:1033587035
Name:COYLE, AMY SUZANNE (CPNP-PC, MSN)
Entity Type:Individual
Prefix:MRS
First Name:AMY
Middle Name:SUZANNE
Last Name:COYLE
Suffix:
Gender:F
Credentials:CPNP-PC, MSN
Other - Prefix:MS
Other - First Name:AMY
Other - Middle Name:SUZANNE
Other - Last Name:APPELBLATT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:804 WEST PARK AVE
Mailing Address - Street 2:
Mailing Address - City:OCEAN TOWNSHIP
Mailing Address - State:NJ
Mailing Address - Zip Code:07712
Mailing Address - Country:US
Mailing Address - Phone:732-531-0010
Mailing Address - Fax:
Practice Address - Street 1:804 WEST PARK AVE
Practice Address - Street 2:
Practice Address - City:OCEAN TOWNSHIP
Practice Address - State:NJ
Practice Address - Zip Code:07712
Practice Address - Country:US
Practice Address - Phone:732-531-0010
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-08
Last Update Date:2015-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00585100363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics