Provider Demographics
NPI:1497907117
Name:DAVID, CECILIA W (ACNP)
Entity Type:Individual
Prefix:MS
First Name:CECILIA
Middle Name:W
Last Name:DAVID
Suffix:
Gender:F
Credentials:ACNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 FRANKLIN SQUARE DRIVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:SOMERSET
Mailing Address - State:NJ
Mailing Address - Zip Code:08873-4109
Mailing Address - Country:US
Mailing Address - Phone:908-429-7799
Mailing Address - Fax:866-611-9616
Practice Address - Street 1:100 FRANKLIN SQUARE DRIVE
Practice Address - Street 2:SUITE 201
Practice Address - City:SOMERSET
Practice Address - State:NJ
Practice Address - Zip Code:08873-4109
Practice Address - Country:US
Practice Address - Phone:908-429-7799
Practice Address - Fax:866-611-9616
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-13
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR07545100363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY302960OtherNEW YORK STATE LICENSE
NJ26NR07545100OtherRPN LICENSE
NJ26NN07545100OtherAPN STATE LICENSE
NJ26NN07545100OtherAPN STATE LICENSE