Provider Demographics
NPI:1295041861
Name:GIAQUINTO-O'DONNELL, SUE (APN)
Entity Type:Individual
Prefix:
First Name:SUE
Middle Name:
Last Name:GIAQUINTO-O'DONNELL
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:47 SETON HALL DR
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:NJ
Mailing Address - Zip Code:07436-3612
Mailing Address - Country:US
Mailing Address - Phone:201-337-0229
Mailing Address - Fax:
Practice Address - Street 1:101 MADISON AVE
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07960-7357
Practice Address - Country:US
Practice Address - Phone:973-359-4400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-20
Last Update Date:2010-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00271700363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health