Provider Demographics
NPI:1265321210
Name:TERRANOVA, MADILYN (PA-C)
Entity type:Individual
Prefix:
First Name:MADILYN
Middle Name:
Last Name:TERRANOVA
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 MARSHALL ST
Mailing Address - Street 2:
Mailing Address - City:WEST CALDWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:07006-7919
Mailing Address - Country:US
Mailing Address - Phone:201-259-1606
Mailing Address - Fax:
Practice Address - Street 1:14 MARSHALL ST
Practice Address - Street 2:
Practice Address - City:WEST CALDWELL
Practice Address - State:NJ
Practice Address - Zip Code:07006-7919
Practice Address - Country:US
Practice Address - Phone:201-259-1606
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-02
Last Update Date:2025-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MP00943000363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical