Provider Demographics
NPI:1376095406
Name:MCNIFF, LENA (CRNA)
Entity Type:Individual
Prefix:
First Name:LENA
Middle Name:
Last Name:MCNIFF
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:LENA
Other - Middle Name:
Other - Last Name:DAIT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:12 WRIGHT CT
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07003-6029
Mailing Address - Country:US
Mailing Address - Phone:973-979-4517
Mailing Address - Fax:
Practice Address - Street 1:94 OLD SHORT HILLS RD
Practice Address - Street 2:
Practice Address - City:LIVINGSTON
Practice Address - State:NJ
Practice Address - Zip Code:07039-5672
Practice Address - Country:US
Practice Address - Phone:973-322-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-24
Last Update Date:2019-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR10662300163WP0200X
NJ26NJ00711200367500000X
NJ115844367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163WP0200XNursing Service ProvidersRegistered NursePediatrics