Provider Demographics
NPI:1790038545
Name:BASCARA, CYNTHIA ROMERO (APN)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:ROMERO
Last Name:BASCARA
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 MULE RD
Mailing Address - Street 2:SUITE E6
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08755-5043
Mailing Address - Country:US
Mailing Address - Phone:732-505-5050
Mailing Address - Fax:
Practice Address - Street 1:527 RIVER AVE.
Practice Address - Street 2:FOUNTAINVIEW CARE CENTER
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701
Practice Address - Country:US
Practice Address - Phone:609-610-7644
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-17
Last Update Date:2012-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00295500364SA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SA2200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAdult Health