Provider Demographics
NPI:1326002569
Name:TRUXAL, MAY (NP)
Entity Type:Individual
Prefix:
First Name:MAY
Middle Name:
Last Name:TRUXAL
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 1:100 HWY 36
Mailing Address - Street 2:SUITE 2C
Mailing Address - City:WEST LONG BRANCH
Mailing Address - State:NJ
Mailing Address - Zip Code:07764-1453
Mailing Address - Country:US
Mailing Address - Phone:732-222-4474
Mailing Address - Fax:732-222-4472
Practice Address - Street 1:279 3RD AVE
Practice Address - Street 2:SUITE 604
Practice Address - City:LONG BRANCH
Practice Address - State:NJ
Practice Address - Zip Code:07740-6205
Practice Address - Country:US
Practice Address - Phone:732-222-4474
Practice Address - Fax:732-222-4472
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ26NN05531800363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8576203Medicaid
NJ049153Medicare ID - Type Unspecified
NJP35316Medicare UPIN