Provider Demographics
NPI:1326451782
Name:SHERRIE COLANERIDAY NPC LLC
Entity Type:Organization
Organization Name:SHERRIE COLANERIDAY NPC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FNP/PRESDIENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHERRIE
Authorized Official - Middle Name:
Authorized Official - Last Name:COLANERI-DAY
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:856-455-1800
Mailing Address - Street 1:700 N PEARL ST
Mailing Address - Street 2:
Mailing Address - City:BRIDGETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08302-1208
Mailing Address - Country:US
Mailing Address - Phone:856-455-1800
Mailing Address - Fax:856-455-7765
Practice Address - Street 1:700 N PEARL ST
Practice Address - Street 2:
Practice Address - City:BRIDGETON
Practice Address - State:NJ
Practice Address - Zip Code:08302-1208
Practice Address - Country:US
Practice Address - Phone:856-455-1800
Practice Address - Fax:856-455-7765
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-03
Last Update Date:2014-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJNN08411261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ025645Medicare PIN