Provider Demographics
NPI:1437629367
Name:TORTORELLA GENOVA, TONI (DNP, APN-C, FNP-BC)
Entity Type:Individual
Prefix:DR
First Name:TONI
Middle Name:
Last Name:TORTORELLA GENOVA
Suffix:
Gender:F
Credentials:DNP, APN-C, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 CLINTON AVE
Mailing Address - Street 2:
Mailing Address - City:RIDGEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07450-3603
Mailing Address - Country:US
Mailing Address - Phone:201-445-3432
Mailing Address - Fax:
Practice Address - Street 1:75 ESSEX ST STE 100
Practice Address - Street 2:
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601-4034
Practice Address - Country:US
Practice Address - Phone:201-343-2478
Practice Address - Fax:201-518-8494
Is Sole Proprietor?:No
Enumeration Date:2018-12-04
Last Update Date:2018-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00748000363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily