Provider Demographics
NPI:1790468619
Name:MAINARDI, DANIELLE GINA (PMHNP)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:GINA
Last Name:MAINARDI
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 COMMERCE DR
Mailing Address - Street 2:
Mailing Address - City:CRANFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:07016-3527
Mailing Address - Country:US
Mailing Address - Phone:908-636-9192
Mailing Address - Fax:
Practice Address - Street 1:16 COMMERCE DR
Practice Address - Street 2:
Practice Address - City:CRANFORD
Practice Address - State:NJ
Practice Address - Zip Code:07016-3527
Practice Address - Country:US
Practice Address - Phone:866-935-4424
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-08
Last Update Date:2023-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ14893900363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health