Provider Demographics
NPI:1063209666
Name:THE NP PROMISE
Entity type:Organization
Organization Name:THE NP PROMISE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWER/PMHNP
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:
Authorized Official - Last Name:MONESTIME
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-304-7068
Mailing Address - Street 1:1199 US HIGHWAY 22
Mailing Address - Street 2:
Mailing Address - City:MOUNTAINSIDE
Mailing Address - State:NJ
Mailing Address - Zip Code:07092-2807
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1199 US HIGHWAY 22
Practice Address - Street 2:
Practice Address - City:MOUNTAINSIDE
Practice Address - State:NJ
Practice Address - Zip Code:07092-2807
Practice Address - Country:US
Practice Address - Phone:973-434-5030
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-24
Last Update Date:2025-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty