Provider Demographics
NPI:1922580596
Name:MEROLA, TERESA L (MSN,RN,PNP-BC)
Entity Type:Individual
Prefix:
First Name:TERESA
Middle Name:L
Last Name:MEROLA
Suffix:
Gender:F
Credentials:MSN,RN,PNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2106 NEW RD STE F1
Mailing Address - Street 2:
Mailing Address - City:LINWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08221-1053
Mailing Address - Country:US
Mailing Address - Phone:609-926-5451
Mailing Address - Fax:609-926-5451
Practice Address - Street 1:1304 LAUREL OAK RD
Practice Address - Street 2:
Practice Address - City:VOORHEES
Practice Address - State:NJ
Practice Address - Zip Code:08043-4310
Practice Address - Country:US
Practice Address - Phone:856-346-3300
Practice Address - Fax:856-346-3462
Is Sole Proprietor?:No
Enumeration Date:2018-08-30
Last Update Date:2018-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00367500363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics