Provider Demographics
NPI:1669593554
Name:VILARDI, EILEEN BRIDGET (RNAPNC)
Entity type:Individual
Prefix:MRS
First Name:EILEEN
Middle Name:BRIDGET
Last Name:VILARDI
Suffix:
Gender:F
Credentials:RNAPNC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:126 HENDRICKSON PL
Mailing Address - Street 2:
Mailing Address - City:FAIR HAVEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07704-3407
Mailing Address - Country:US
Mailing Address - Phone:732-530-4025
Mailing Address - Fax:
Practice Address - Street 1:68 FORMAN ST
Practice Address - Street 2:
Practice Address - City:FAIR HAVEN
Practice Address - State:NJ
Practice Address - Zip Code:07704-3242
Practice Address - Country:US
Practice Address - Phone:732-747-2590
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NC05198700364SP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Adult