Provider Demographics
NPI: | 1407450075 |
---|---|
Name: | MUNKACSY, GINA MARIE (APN) |
Entity type: | Individual |
Prefix: | MS |
First Name: | GINA |
Middle Name: | MARIE |
Last Name: | MUNKACSY |
Suffix: | |
Gender: | F |
Credentials: | APN |
Other - Prefix: | |
Other - First Name: | |
Other - Middle Name: | |
Other - Last Name: | |
Other - Suffix: | |
Other - Last Name Type: | |
Other - Credentials: | |
Mailing Address - Street 1: | 70 ELSTON CT |
Mailing Address - Street 2: | |
Mailing Address - City: | HASKELL |
Mailing Address - State: | NJ |
Mailing Address - Zip Code: | 07420-1151 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 732-501-9530 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 300 GRAND AVE |
Practice Address - Street 2: | |
Practice Address - City: | ENGLEWOOD |
Practice Address - State: | NJ |
Practice Address - Zip Code: | 07631-4398 |
Practice Address - Country: | US |
Practice Address - Phone: | 201-816-1900 |
Practice Address - Fax: | 201-816-1777 |
Is Sole Proprietor?: | No |
Enumeration Date: | 2020-11-24 |
Last Update Date: | 2025-01-27 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
NJ | 26NJ01037300 | 363LA2100X, 363LG0600X, 363L00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 363L00000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | |
No | 363LA2100X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Acute Care |
No | 363LG0600X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Gerontology |