Provider Demographics
NPI:1215035613
Name:EMERY-MORRIS, MARLENE (APRN, BC)
Entity Type:Individual
Prefix:
First Name:MARLENE
Middle Name:
Last Name:EMERY-MORRIS
Suffix:
Gender:F
Credentials:APRN, BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 GARRETSON DR
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:08823-1423
Mailing Address - Country:US
Mailing Address - Phone:732-422-4491
Mailing Address - Fax:
Practice Address - Street 1:47 RARITAN AVENUE
Practice Address - Street 2:SUITE # 130
Practice Address - City:HIGHLAND PARK
Practice Address - State:NJ
Practice Address - Zip Code:08904-2440
Practice Address - Country:US
Practice Address - Phone:732-422-6665
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NC06364000363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health