Provider Demographics
NPI:1871841478
Name:VENTOLA, ANDREA LYNN (WHNP-BC)
Entity Type:Individual
Prefix:MS
First Name:ANDREA
Middle Name:LYNN
Last Name:VENTOLA
Suffix:
Gender:F
Credentials:WHNP-BC
Other - Prefix:
Other - First Name:ANDREA
Other - Middle Name:LYNN
Other - Last Name:SOUSA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:WHNP-BC
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:08901-1914
Mailing Address - Country:US
Mailing Address - Phone:732-235-2465
Mailing Address - Fax:
Practice Address - Street 1:150 PARK AVE
Practice Address - Street 2:
Practice Address - City:FLORHAM PARK
Practice Address - State:NJ
Practice Address - Zip Code:07932-1049
Practice Address - Country:US
Practice Address - Phone:973-404-9700
Practice Address - Fax:973-660-0248
Is Sole Proprietor?:No
Enumeration Date:2012-08-29
Last Update Date:2019-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00389500363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology