Provider Demographics
NPI:1033959317
Name:CECCHETTO, LAURA RINA (FNP-BC)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:RINA
Last Name:CECCHETTO
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MENDHAM
Mailing Address - State:NJ
Mailing Address - Zip Code:07945-1503
Mailing Address - Country:US
Mailing Address - Phone:973-543-6505
Mailing Address - Fax:973-543-2967
Practice Address - Street 1:19 E MAIN ST
Practice Address - Street 2:
Practice Address - City:MENDHAM
Practice Address - State:NJ
Practice Address - Zip Code:07945-1503
Practice Address - Country:US
Practice Address - Phone:973-543-6505
Practice Address - Fax:973-543-2967
Is Sole Proprietor?:No
Enumeration Date:2024-05-25
Last Update Date:2025-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ15036000363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily