Provider Demographics
NPI:1013211838
Name:PABON, MIRIAM JUDITH (APN-BC)
Entity Type:Individual
Prefix:MS
First Name:MIRIAM
Middle Name:JUDITH
Last Name:PABON
Suffix:
Gender:F
Credentials:APN-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:740 ROUTE 1 N
Mailing Address - Street 2:
Mailing Address - City:ISELIN
Mailing Address - State:NJ
Mailing Address - Zip Code:08830-2652
Mailing Address - Country:US
Mailing Address - Phone:732-726-0011
Mailing Address - Fax:
Practice Address - Street 1:740 ROUTE 1 N
Practice Address - Street 2:
Practice Address - City:ISELIN
Practice Address - State:NJ
Practice Address - Zip Code:08830-2652
Practice Address - Country:US
Practice Address - Phone:732-726-0011
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-01-09
Last Update Date:2011-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00312500363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily