Provider Demographics
NPI:1083764823
Name:ANSELMO-MURPHY, ANNE M
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:M
Last Name:ANSELMO-MURPHY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 JUMPING BROOK RD
Mailing Address - Street 2:BLDG 5
Mailing Address - City:NEPTUNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07753-2634
Mailing Address - Country:US
Mailing Address - Phone:732-643-4321
Mailing Address - Fax:732-481-8519
Practice Address - Street 1:1945 ROUTE 33
Practice Address - Street 2:JERSEY SHORE UNIVERSITY MEDICAL CENTER
Practice Address - City:NEPTUNE
Practice Address - State:NJ
Practice Address - Zip Code:07753-4859
Practice Address - Country:US
Practice Address - Phone:732-202-8071
Practice Address - Fax:732-241-9905
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-12
Last Update Date:2012-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NN075047363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8576807Medicaid
050192Medicare PIN
P37838Medicare UPIN
NJ152378AHEMedicare PIN