Provider Demographics
NPI:1952392128
Name:NUCIFORA, DENISE (CRNP)
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:
Last Name:NUCIFORA
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 COOPER PLZ
Mailing Address - Street 2:SUITE 411
Mailing Address - City:CAMDEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08103-1438
Mailing Address - Country:US
Mailing Address - Phone:856-963-3695
Mailing Address - Fax:856-365-1180
Practice Address - Street 1:3 COOPER PLAZA
Practice Address - Street 2:SUITE 411
Practice Address - City:CAMDEN
Practice Address - State:NJ
Practice Address - Zip Code:08103-1438
Practice Address - Country:US
Practice Address - Phone:856-963-3695
Practice Address - Fax:856-365-1180
Is Sole Proprietor?:No
Enumeration Date:2005-11-04
Last Update Date:2009-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJNJ00067600208600000X
PATP003196U363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA094857Medicare ID - Type Unspecified
Q23635Medicare UPIN