Provider Demographics
NPI:1144796863
Name:VASQUEZ, AILEEN JOANNA ALMEDA (FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:AILEEN JOANNA ALMEDA
Middle Name:
Last Name:VASQUEZ
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1912 HIGHWAY 35 STE 201
Mailing Address - Street 2:
Mailing Address - City:OAKHURST
Mailing Address - State:NJ
Mailing Address - Zip Code:07755-2768
Mailing Address - Country:US
Mailing Address - Phone:732-389-5004
Mailing Address - Fax:732-548-7408
Practice Address - Street 1:1912 HIGHWAY 35 STE 201
Practice Address - Street 2:
Practice Address - City:OAKHURST
Practice Address - State:NJ
Practice Address - Zip Code:07755-2768
Practice Address - Country:US
Practice Address - Phone:732-389-5004
Practice Address - Fax:732-548-7408
Is Sole Proprietor?:No
Enumeration Date:2018-10-19
Last Update Date:2018-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00868400363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily