Provider Demographics
NPI:1104296524
Name:DUNCAN, IVETTE AMNERYS (APN)
Entity type:Individual
Prefix:MISS
First Name:IVETTE
Middle Name:AMNERYS
Last Name:DUNCAN
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:IVETTE
Other - Middle Name:AMNERYS
Other - Last Name:MARTINEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:301 LIPPINCOTT DR STE 410
Mailing Address - Street 2:
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-4197
Mailing Address - Country:US
Mailing Address - Phone:856-355-7118
Mailing Address - Fax:856-325-5222
Practice Address - Street 1:218A SUNSET RD FL 1
Practice Address - Street 2:
Practice Address - City:WILLINGBORO
Practice Address - State:NJ
Practice Address - Zip Code:08046-1110
Practice Address - Country:US
Practice Address - Phone:856-355-7118
Practice Address - Fax:856-325-5222
Is Sole Proprietor?:No
Enumeration Date:2015-09-28
Last Update Date:2025-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00591600363LP0808X, 363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0484636Medicaid
NJ456473N4XMedicare PIN