Provider Demographics
NPI:1346987161
Name:NEMBHARD-HIBBERT, MONIQUE D
Entity Type:Individual
Prefix:MRS
First Name:MONIQUE
Middle Name:D
Last Name:NEMBHARD-HIBBERT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:485C ROUTE 1 STE 100
Mailing Address - Street 2:
Mailing Address - City:ISELIN
Mailing Address - State:NJ
Mailing Address - Zip Code:08830-3016
Mailing Address - Country:US
Mailing Address - Phone:732-433-2319
Mailing Address - Fax:
Practice Address - Street 1:485C ROUTE 1 STE 100
Practice Address - Street 2:
Practice Address - City:ISELIN
Practice Address - State:NJ
Practice Address - Zip Code:08830-3016
Practice Address - Country:US
Practice Address - Phone:732-433-2319
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-13
Last Update Date:2022-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ172V00000X, 171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No172V00000XOther Service ProvidersCommunity Health Worker