Provider Demographics
NPI:1295498251
Name:MARQUEZ, ANEL IVETH (AGPCNP-BC)
Entity type:Individual
Prefix:MRS
First Name:ANEL
Middle Name:IVETH
Last Name:MARQUEZ
Suffix:
Gender:F
Credentials:AGPCNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:94 SPENCER AVE
Mailing Address - Street 2:
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07013-2831
Mailing Address - Country:US
Mailing Address - Phone:973-704-0685
Mailing Address - Fax:
Practice Address - Street 1:205 BROWERTOWN RD STE 205
Practice Address - Street 2:
Practice Address - City:WOODLAND PARK
Practice Address - State:NJ
Practice Address - Zip Code:07424-2610
Practice Address - Country:US
Practice Address - Phone:973-569-6112
Practice Address - Fax:973-837-6780
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-18
Last Update Date:2021-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ01210100363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care