Provider Demographics
NPI:1477035715
Name:PANDOLA-DILOLLE, KAREN E (AGACNP-BC)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:E
Last Name:PANDOLA-DILOLLE
Suffix:
Gender:F
Credentials:AGACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 DIAMOND HILL RD
Mailing Address - Street 2:
Mailing Address - City:BERKELEY HEIGHTS
Mailing Address - State:NJ
Mailing Address - Zip Code:07922-2104
Mailing Address - Country:US
Mailing Address - Phone:908-273-4300
Mailing Address - Fax:
Practice Address - Street 1:222 NEW RD STE 700
Practice Address - Street 2:
Practice Address - City:LINWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08221-1286
Practice Address - Country:US
Practice Address - Phone:609-653-4343
Practice Address - Fax:609-653-2060
Is Sole Proprietor?:No
Enumeration Date:2018-09-04
Last Update Date:2022-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NO10707900163WU0100X, 363L00000X
NJ26NJ00828600363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163WU0100XNursing Service ProvidersRegistered NurseUrology
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care