Provider Demographics
NPI:1013080282
Name:CIERI, EILEEN (NP)
Entity Type:Individual
Prefix:MS
First Name:EILEEN
Middle Name:
Last Name:CIERI
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 THROCKMORTON AVE
Mailing Address - Street 2:
Mailing Address - City:WEST LONG BRANCH
Mailing Address - State:NJ
Mailing Address - Zip Code:07764-1318
Mailing Address - Country:US
Mailing Address - Phone:732-229-9303
Mailing Address - Fax:732-974-0137
Practice Address - Street 1:1925 STATE ROUTE 35
Practice Address - Street 2:
Practice Address - City:WALL TOWNSHIP
Practice Address - State:NJ
Practice Address - Zip Code:07719-3512
Practice Address - Country:US
Practice Address - Phone:732-974-0100
Practice Address - Fax:732-974-0137
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-16
Last Update Date:2010-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NNO6837100363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJS67895Medicare UPIN