Provider Demographics
NPI:1114970530
Name:CORD, CARLENE ANGELA (APN)
Entity Type:Individual
Prefix:MRS
First Name:CARLENE
Middle Name:ANGELA
Last Name:CORD
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
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Mailing Address - Street 1:96 DOGWOOD CT
Mailing Address - Street 2:
Mailing Address - City:WESTWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07675-3508
Mailing Address - Country:US
Mailing Address - Phone:201-666-7673
Mailing Address - Fax:
Practice Address - Street 1:30 PROSPECT AVE
Practice Address - Street 2:HACKENSACK UNIVERSITY MEDICAL CENTER- TOMMORROWS CHILDR
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601
Practice Address - Country:US
Practice Address - Phone:201-996-5437
Practice Address - Fax:201-457-1885
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-18
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00071000364SP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPediatrics