Provider Demographics
NPI:1235127309
Name:CIMORELLI, MONIQUE (NP)
Entity Type:Individual
Prefix:MS
First Name:MONIQUE
Middle Name:
Last Name:CIMORELLI
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 E FRANKLIN AVE
Mailing Address - Street 2:
Mailing Address - City:EDGEWATER PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:08010-1846
Mailing Address - Country:US
Mailing Address - Phone:609-605-8035
Mailing Address - Fax:609-526-5799
Practice Address - Street 1:680 BLAIR MILL RD
Practice Address - Street 2:
Practice Address - City:HORSHAM
Practice Address - State:PA
Practice Address - Zip Code:19044-2223
Practice Address - Country:US
Practice Address - Phone:866-297-9232
Practice Address - Fax:888-816-8109
Is Sole Proprietor?:No
Enumeration Date:2005-10-12
Last Update Date:2014-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NN10761400363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7748604Medicaid
NJ019855XVAMedicare UPIN
NJ019855R63Medicare ID - Type Unspecified
NJS64156Medicare UPIN