Provider Demographics
NPI:1376548917
Name:TEIXEIRA, MARY ELIZABETH (DRNP)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:ELIZABETH
Last Name:TEIXEIRA
Suffix:
Gender:F
Credentials:DRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:59 ONE MILE RD EXT
Mailing Address - Street 2:
Mailing Address - City:EAST WINDSOR
Mailing Address - State:NJ
Mailing Address - Zip Code:08520-2505
Mailing Address - Country:US
Mailing Address - Phone:609-268-2261
Mailing Address - Fax:
Practice Address - Street 1:59 ONE MILE RD EXT
Practice Address - Street 2:
Practice Address - City:EAST WINDSOR
Practice Address - State:NJ
Practice Address - Zip Code:08520-2505
Practice Address - Country:US
Practice Address - Phone:609-443-0041
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-06-20
Last Update Date:2011-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NN08408200363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJS66484Medicare UPIN
NJ020998N5HMedicare ID - Type Unspecified