Provider Demographics
NPI:1710720966
Name:ZAMOR, ISMENE (APN, PMHNP-BC)
Entity type:Individual
Prefix:
First Name:ISMENE
Middle Name:
Last Name:ZAMOR
Suffix:
Gender:F
Credentials:APN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:138 CISELEY DR
Mailing Address - Street 2:
Mailing Address - City:SICKLERVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08081-5718
Mailing Address - Country:US
Mailing Address - Phone:908-858-7966
Mailing Address - Fax:
Practice Address - Street 1:6811 BLACK HORSE PIKE STE 131
Practice Address - Street 2:
Practice Address - City:EGG HARBOR TWP
Practice Address - State:NJ
Practice Address - Zip Code:08234-4131
Practice Address - Country:US
Practice Address - Phone:609-484-8175
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-17
Last Update Date:2024-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ15077600363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health