Provider Demographics
NPI:1679562482
Name:GERMAIN, JANICE L (APN C)
Entity Type:Individual
Prefix:
First Name:JANICE
Middle Name:L
Last Name:GERMAIN
Suffix:
Gender:F
Credentials:APN C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:195 LITTLE ALBANY ST
Mailing Address - Street 2:
Mailing Address - City:NEW BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08903-1914
Mailing Address - Country:US
Mailing Address - Phone:732-235-6018
Mailing Address - Fax:732-235-3299
Practice Address - Street 1:195 LITTLE ALBANY ST
Practice Address - Street 2:
Practice Address - City:NEW BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08903-1914
Practice Address - Country:US
Practice Address - Phone:732-235-6018
Practice Address - Fax:732-235-3299
Is Sole Proprietor?:No
Enumeration Date:2005-10-14
Last Update Date:2013-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00068900363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0054500Medicaid
NJ085767AR4Medicare ID - Type Unspecified
NJ085767AHEMedicare PIN
Q29394Medicare UPIN
NJ0054500Medicaid