Provider Demographics
NPI:1659971976
Name:TADEJ, HEATHER ANN (APN)
Entity Type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:ANN
Last Name:TADEJ
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:206 BREWSTER AVE
Mailing Address - Street 2:
Mailing Address - City:PISCATAWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:08854-2347
Mailing Address - Country:US
Mailing Address - Phone:732-770-0561
Mailing Address - Fax:
Practice Address - Street 1:98 JAMES ST
Practice Address - Street 2:
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08820-3902
Practice Address - Country:US
Practice Address - Phone:732-230-2828
Practice Address - Fax:732-230-2479
Is Sole Proprietor?:No
Enumeration Date:2020-10-27
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ01066400363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology