Provider Demographics
NPI:1841359155
Name:HONCHARUK, LOIS (RN,C,PNP)
Entity type:Individual
Prefix:
First Name:LOIS
Middle Name:
Last Name:HONCHARUK
Suffix:
Gender:F
Credentials:RN,C,PNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1037 ROUTE 46
Mailing Address - Street 2:
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07013-2451
Mailing Address - Country:US
Mailing Address - Phone:973-779-3911
Mailing Address - Fax:
Practice Address - Street 1:1037 ROUTE 46
Practice Address - Street 2:
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07013-2451
Practice Address - Country:US
Practice Address - Phone:973-779-3911
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-06
Last Update Date:2020-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NN05970500363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily