Provider Demographics
NPI:1700132669
Name:REISENAUER, MONIKA SCHULE (MSN, APRN, NNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:MONIKA
Middle Name:SCHULE
Last Name:REISENAUER
Suffix:
Gender:F
Credentials:MSN, APRN, NNP-BC
Other - Prefix:
Other - First Name:MONIKA
Other - Middle Name:
Other - Last Name:SCHULE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1 GUSTAVE L LEVY PL
Mailing Address - Street 2:BOX 1153 (NICU)
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029-6500
Mailing Address - Country:US
Mailing Address - Phone:845-323-7887
Mailing Address - Fax:
Practice Address - Street 1:140 E RIDGEWOOD AVE STE 480N
Practice Address - Street 2:
Practice Address - City:PARAMUS
Practice Address - State:NJ
Practice Address - Zip Code:07652-3917
Practice Address - Country:US
Practice Address - Phone:201-447-8151
Practice Address - Fax:201-857-0278
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-30
Last Update Date:2021-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY605091163WN0002X
NY350344363LN0005X
NJ26NJ00857700363LN0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal
No163WN0002XNursing Service ProvidersRegistered NurseNeonatal Intensive Care
No363LN0005XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal, Critical Care