Provider Demographics
NPI:1245453703
Name:PADRE, IRENE VENALES (NP)
Entity type:Individual
Prefix:MRS
First Name:IRENE
Middle Name:VENALES
Last Name:PADRE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:375 MOUNT PLEASANT AVE
Mailing Address - Street 2:
Mailing Address - City:WEST ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07052-2750
Mailing Address - Country:US
Mailing Address - Phone:973-731-9442
Mailing Address - Fax:973-731-2918
Practice Address - Street 1:375 MOUNT PLEASANT AVE
Practice Address - Street 2:
Practice Address - City:WEST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07052-2750
Practice Address - Country:US
Practice Address - Phone:973-731-9442
Practice Address - Fax:973-731-2918
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-11
Last Update Date:2023-02-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00023400363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care