Provider Demographics
NPI:1770062960
Name:DE CRISCE, MARTHA E (DNP, APN, FNP-C)
Entity type:Individual
Prefix:DR
First Name:MARTHA
Middle Name:E
Last Name:DE CRISCE
Suffix:
Gender:F
Credentials:DNP, APN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:974 HARDING RD
Mailing Address - Street 2:
Mailing Address - City:ELIZABETH
Mailing Address - State:NJ
Mailing Address - Zip Code:07208-1048
Mailing Address - Country:US
Mailing Address - Phone:310-902-2536
Mailing Address - Fax:
Practice Address - Street 1:38 ELMORA AVE
Practice Address - Street 2:
Practice Address - City:ELIZABETH
Practice Address - State:NJ
Practice Address - Zip Code:07202-2248
Practice Address - Country:US
Practice Address - Phone:908-576-8982
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-09
Last Update Date:2018-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00845200363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily