Provider Demographics
NPI:1326337734
Name:LADANI, DEEPA H (NP)
Entity Type:Individual
Prefix:
First Name:DEEPA
Middle Name:H
Last Name:LADANI
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 1:555 IRON BRIDGE RD
Mailing Address - Street 2:SUITE 12
Mailing Address - City:FREEHOLD
Mailing Address - State:NJ
Mailing Address - Zip Code:07728-2975
Mailing Address - Country:US
Mailing Address - Phone:732-409-5353
Mailing Address - Fax:
Practice Address - Street 1:555 IRONBRIDGE ROAD
Practice Address - Street 2:SUITE 12
Practice Address - City:FREEHOLD
Practice Address - State:NJ
Practice Address - Zip Code:07728
Practice Address - Country:US
Practice Address - Phone:732-409-5353
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-06
Last Update Date:2011-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00313000363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health