Provider Demographics
NPI:1780921551
Name:MAC, ARIANE (FNP, DNP)
Entity type:Individual
Prefix:DR
First Name:ARIANE
Middle Name:
Last Name:MAC
Suffix:
Gender:F
Credentials:FNP, DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 BROEMEL PL UNIT 150
Mailing Address - Street 2:
Mailing Address - City:PENNINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08534-8006
Mailing Address - Country:US
Mailing Address - Phone:609-658-3181
Mailing Address - Fax:
Practice Address - Street 1:30 MONTGOMERY ST
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07302-3829
Practice Address - Country:US
Practice Address - Phone:609-658-3181
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-13
Last Update Date:2024-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00390900363LF0000X
PASP012398363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily