Provider Demographics
NPI:1508942269
Name:BREY, NANCY (MSN, CNSC)
Entity Type:Individual
Prefix:MS
First Name:NANCY
Middle Name:
Last Name:BREY
Suffix:
Gender:F
Credentials:MSN, CNSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:160 MYRTLE AVE
Mailing Address - Street 2:
Mailing Address - City:ALLENDALE
Mailing Address - State:NJ
Mailing Address - Zip Code:07401-1518
Mailing Address - Country:US
Mailing Address - Phone:201-390-0067
Mailing Address - Fax:201-487-3903
Practice Address - Street 1:450 SUMMIT AVE
Practice Address - Street 2:
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601-1503
Practice Address - Country:US
Practice Address - Phone:201-487-9104
Practice Address - Fax:201-487-3903
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR04560800163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ050341Medicare ID - Type Unspecified