Provider Demographics
NPI:1730527045
Name:ARDAN, MARGO SELINA (RN)
Entity type:Individual
Prefix:
First Name:MARGO
Middle Name:SELINA
Last Name:ARDAN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 LITTLE KNOLL CT
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:08055-8505
Mailing Address - Country:US
Mailing Address - Phone:609-680-5431
Mailing Address - Fax:
Practice Address - Street 1:1 LITTLE KNOLL CT
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:NJ
Practice Address - Zip Code:08055-8505
Practice Address - Country:US
Practice Address - Phone:609-680-5431
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-08
Last Update Date:2013-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ517728146N00000X
NJ26NR14808200163WM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical
No146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, Basic