Provider Demographics
NPI:1174508188
Name:SIMMONS-ROMANO, MONIQUE (DNP,, APN,C)
Entity Type:Individual
Prefix:DR
First Name:MONIQUE
Middle Name:
Last Name:SIMMONS-ROMANO
Suffix:
Gender:F
Credentials:DNP,, APN,C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:131 MORRISTOWN RD
Mailing Address - Street 2:
Mailing Address - City:BASKING RIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07920-1654
Mailing Address - Country:US
Mailing Address - Phone:646-942-7206
Mailing Address - Fax:
Practice Address - Street 1:131 MORRISTOWN RD
Practice Address - Street 2:
Practice Address - City:BASKING RIDGE
Practice Address - State:NJ
Practice Address - Zip Code:07920-1654
Practice Address - Country:US
Practice Address - Phone:646-942-7206
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-13
Last Update Date:2015-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJNN104995363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8448205Medicaid
NJP19756Medicare UPIN
NJ043964N57Medicare Oscar/Certification