Provider Demographics
NPI:1730146952
Name:SINICOLA-REES, JUDITH (RN APN C)
Entity type:Individual
Prefix:
First Name:JUDITH
Middle Name:
Last Name:SINICOLA-REES
Suffix:
Gender:F
Credentials:RN APN C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 GLENVIEW RD
Mailing Address - Street 2:
Mailing Address - City:NORTH CALDWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:07006-3903
Mailing Address - Country:US
Mailing Address - Phone:908-522-2970
Mailing Address - Fax:908-522-4888
Practice Address - Street 1:46-48 BEAUVOIR AVE
Practice Address - Street 2:OVERLOOK MEDICAL CENTER
Practice Address - City:SUMMIT
Practice Address - State:NJ
Practice Address - Zip Code:07901
Practice Address - Country:US
Practice Address - Phone:908-522-2970
Practice Address - Fax:908-522-4888
Is Sole Proprietor?:No
Enumeration Date:2006-05-01
Last Update Date:2016-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NC07488900363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7363800Medicaid
NJ7363800Medicaid
NJS45306Medicare ID - Type Unspecified