Provider Demographics
NPI:1033862016
Name:NAZAIRE MEDICAL GROUP
Entity Type:Organization
Organization Name:NAZAIRE MEDICAL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER & CEO/NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:MARTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:NAZAIRE
Authorized Official - Suffix:
Authorized Official - Credentials:MSN-RN, APN-C, CWS
Authorized Official - Phone:732-898-2953
Mailing Address - Street 1:283 MONMOUTH RD
Mailing Address - Street 2:
Mailing Address - City:FREEHOLD
Mailing Address - State:NJ
Mailing Address - Zip Code:07728-7933
Mailing Address - Country:US
Mailing Address - Phone:732-898-2953
Mailing Address - Fax:
Practice Address - Street 1:283 MONMOUTH RD
Practice Address - Street 2:
Practice Address - City:FREEHOLD
Practice Address - State:NJ
Practice Address - Zip Code:07728-7933
Practice Address - Country:US
Practice Address - Phone:732-898-2953
Practice Address - Fax:732-353-0203
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-31
Last Update Date:2023-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty