Provider Demographics
NPI:1225085558
Name:CARPENITO, LYNDA J (NP)
Entity Type:Individual
Prefix:
First Name:LYNDA
Middle Name:J
Last Name:CARPENITO
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:LYNDA
Other - Middle Name:J
Other - Last Name:MOYET
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:400 BROADACRES DRIVE
Mailing Address - Street 2:4TH FLOOR
Mailing Address - City:BLOOMFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07003-3156
Mailing Address - Country:US
Mailing Address - Phone:973-661-8300
Mailing Address - Fax:973-661-8333
Practice Address - Street 1:500 SOUTHERN BLVD
Practice Address - Street 2:
Practice Address - City:CHATHAM
Practice Address - State:NJ
Practice Address - Zip Code:07928
Practice Address - Country:US
Practice Address - Phone:610-872-6131
Practice Address - Fax:610-872-5128
Is Sole Proprietor?:No
Enumeration Date:2006-05-30
Last Update Date:2018-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZTRN13056363L00000X
NJ26NN04564500363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA100930772-001Medicaid