Provider Demographics
NPI:1538707682
Name:CHURSANOVA, SVITLANA (NP)
Entity type:Individual
Prefix:
First Name:SVITLANA
Middle Name:
Last Name:CHURSANOVA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41 SHORT HILLS CIR APT 2B
Mailing Address - Street 2:
Mailing Address - City:MILLBURN
Mailing Address - State:NJ
Mailing Address - Zip Code:07041-1237
Mailing Address - Country:US
Mailing Address - Phone:973-704-5713
Mailing Address - Fax:
Practice Address - Street 1:41 SHORT HILLS CIR APT 2B
Practice Address - Street 2:
Practice Address - City:MILLBURN
Practice Address - State:NJ
Practice Address - Zip Code:07041-1237
Practice Address - Country:US
Practice Address - Phone:973-704-5713
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-18
Last Update Date:2019-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00985100363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care