Provider Demographics
NPI:1891765335
Name:POIANIDAROCKI, LANDA ANN (CNP)
Entity Type:Individual
Prefix:
First Name:LANDA
Middle Name:ANN
Last Name:POIANIDAROCKI
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1440 DORSETT DR
Mailing Address - Street 2:
Mailing Address - City:WALL TOWNSHIP
Mailing Address - State:NJ
Mailing Address - Zip Code:07719-9646
Mailing Address - Country:US
Mailing Address - Phone:732-776-4251
Mailing Address - Fax:732-776-4210
Practice Address - Street 1:81-03 DAVIS AVENUE
Practice Address - Street 2:
Practice Address - City:NEPTUNE
Practice Address - State:NJ
Practice Address - Zip Code:07753
Practice Address - Country:US
Practice Address - Phone:732-776-4251
Practice Address - Fax:732-776-4210
Is Sole Proprietor?:No
Enumeration Date:2006-01-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NN07335200363LX0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0106XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerOccupational Health