Provider Demographics
NPI:1417031113
Name:PATELLA, SONDRA J (MSN;RN;ANP,C)
Entity type:Individual
Prefix:MRS
First Name:SONDRA
Middle Name:J
Last Name:PATELLA
Suffix:
Gender:F
Credentials:MSN;RN;ANP,C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 PATERSON ST
Mailing Address - Street 2:5TH FLOOR SUITE 5200
Mailing Address - City:NEW BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08901-1962
Mailing Address - Country:US
Mailing Address - Phone:732-235-6561
Mailing Address - Fax:732-235-6530
Practice Address - Street 1:125 PATERSON ST
Practice Address - Street 2:5TH FLOOR SUITE 5200
Practice Address - City:NEW BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08901-1962
Practice Address - Country:US
Practice Address - Phone:732-235-6561
Practice Address - Fax:732-235-6530
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NN07350800363LA2200X
NJNN 073508363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1094178OtherHORIZON NJ HEALTH
NJ7549105Medicaid
NJ890000846OtherRAILROAD MEDICARE
NJP1251016OtherOXFORD
NJ890000846OtherRAILROAD MEDICARE