Provider Demographics
NPI:1881283570
Name:CINTRON, DOMINIQUE (APRN)
Entity type:Individual
Prefix:MRS
First Name:DOMINIQUE
Middle Name:
Last Name:CINTRON
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:MRS
Other - First Name:DOMINIQUE
Other - Middle Name:
Other - Last Name:AVERY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1 N WHITE HORSE PIKE
Mailing Address - Street 2:
Mailing Address - City:HAMMONTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08037-1875
Mailing Address - Country:US
Mailing Address - Phone:609-567-0434
Mailing Address - Fax:
Practice Address - Street 1:5034 ATLANTIC AVE
Practice Address - Street 2:
Practice Address - City:MAYS LANDING
Practice Address - State:NJ
Practice Address - Zip Code:08330-2022
Practice Address - Country:US
Practice Address - Phone:609-782-0005
Practice Address - Fax:609-829-3857
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-16
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR17551000163W00000X
NJ26NJ01095400363LA2200X, 363LG0600X, 363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No163W00000XNursing Service ProvidersRegistered Nurse
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology