Provider Demographics
NPI:1255582599
Name:BARTHOLOMEW, DJENANE (RN)
Entity type:Individual
Prefix:DR
First Name:DJENANE
Middle Name:
Last Name:BARTHOLOMEW
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MRS
Other - First Name:DJENANE
Other - Middle Name:
Other - Last Name:THIBAUT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:23 DORA LN
Mailing Address - Street 2:
Mailing Address - City:HOLMDEL
Mailing Address - State:NJ
Mailing Address - Zip Code:07733-1624
Mailing Address - Country:US
Mailing Address - Phone:732-888-1355
Mailing Address - Fax:732-888-1639
Practice Address - Street 1:517 53RD ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11220-2736
Practice Address - Country:US
Practice Address - Phone:516-852-2463
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-06
Last Update Date:2021-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY523142-1163W00000X
NYF310460-01363LA2200X
NJ26NR13685400163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health
No163W00000XNursing Service ProvidersRegistered Nurse
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health