Provider Demographics
NPI:1780904789
Name:ANUDON, DAPHNE MARIE (MSN, CRNA)
Entity type:Individual
Prefix:
First Name:DAPHNE
Middle Name:MARIE
Last Name:ANUDON
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Gender:
Credentials:MSN, CRNA
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:68 S SERVICE RD
Mailing Address - Street 2:SUITE 350
Mailing Address - City:MELVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11747-2354
Mailing Address - Country:US
Mailing Address - Phone:516-945-3000
Mailing Address - Fax:516-945-3131
Practice Address - Street 1:300 2ND AVE
Practice Address - Street 2:
Practice Address - City:LONG BRANCH
Practice Address - State:NJ
Practice Address - Zip Code:07740-6303
Practice Address - Country:US
Practice Address - Phone:732-222-5200
Practice Address - Fax:732-923-6519
Is Sole Proprietor?:No
Enumeration Date:2010-06-02
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ26NR09377600367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ197066A01Medicare PIN