Provider Demographics
NPI:1952485914
Name:SAVAGE, BETH (NP)
Entity Type:Individual
Prefix:
First Name:BETH
Middle Name:
Last Name:SAVAGE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:66 W GILBERT ST
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:TINTON FALLS
Mailing Address - State:NJ
Mailing Address - Zip Code:07701-4947
Mailing Address - Country:US
Mailing Address - Phone:732-212-0051
Mailing Address - Fax:732-212-0713
Practice Address - Street 1:195 LITTLE ALBANY ST
Practice Address - Street 2:THE CANCER INSTITUTE OF NEW JERSEY
Practice Address - City:NEW BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08901-1914
Practice Address - Country:US
Practice Address - Phone:732-235-6455
Practice Address - Fax:732-235-6462
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-25
Last Update Date:2011-02-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ26NN10453200363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0062537Medicaid
Q43119Medicare UPIN
090765Medicare PIN
NJ090765AHEMedicare PIN
NJ090765ADXMedicare PIN