Provider Demographics
NPI:1235756834
Name:PAUNON, CAMILLE (AGPCNP-BC)
Entity Type:Individual
Prefix:MS
First Name:CAMILLE
Middle Name:
Last Name:PAUNON
Suffix:
Gender:F
Credentials:AGPCNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 GROVE ST
Mailing Address - Street 2:
Mailing Address - City:BERGENFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07621-2417
Mailing Address - Country:US
Mailing Address - Phone:201-926-0524
Mailing Address - Fax:
Practice Address - Street 1:30 GROVE ST
Practice Address - Street 2:
Practice Address - City:BERGENFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07621-2417
Practice Address - Country:US
Practice Address - Phone:201-926-0524
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-30
Last Update Date:2020-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY676531163W00000X
NY2019059691363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No163W00000XNursing Service ProvidersRegistered Nurse