Provider Demographics
NPI:1114219094
Name:GANTIER, MONIQUE CECELIA (FNP)
Entity type:Individual
Prefix:MRS
First Name:MONIQUE
Middle Name:CECELIA
Last Name:GANTIER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:206 BERGEN AVE STE 207
Mailing Address - Street 2:
Mailing Address - City:KEARNY
Mailing Address - State:NJ
Mailing Address - Zip Code:07032-3387
Mailing Address - Country:US
Mailing Address - Phone:347-204-6090
Mailing Address - Fax:
Practice Address - Street 1:206 BERGEN AVE STE 207
Practice Address - Street 2:
Practice Address - City:KEARNY
Practice Address - State:NJ
Practice Address - Zip Code:07032-3387
Practice Address - Country:US
Practice Address - Phone:347-204-6090
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-10
Last Update Date:2025-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00404700363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily