Provider Demographics
NPI:1922075571
Name:MANFREDI, ADA (MS, FNPC(APN))
Entity Type:Individual
Prefix:MS
First Name:ADA
Middle Name:
Last Name:MANFREDI
Suffix:
Gender:F
Credentials:MS, FNPC(APN)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 E 4TH AVE
Mailing Address - Street 2:
Mailing Address - City:ROSELLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07203-1335
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4 RYAN RD
Practice Address - Street 2:MINUTE CLINIC, LLC
Practice Address - City:MARLBORO
Practice Address - State:NJ
Practice Address - Zip Code:07746-2445
Practice Address - Country:US
Practice Address - Phone:732-431-8700
Practice Address - Fax:732-431-8729
Is Sole Proprietor?:No
Enumeration Date:2006-03-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily