Provider Demographics
NPI:1457745853
Name:CERTO, JUSTINE M (RN)
Entity type:Individual
Prefix:MISS
First Name:JUSTINE
Middle Name:M
Last Name:CERTO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 SCOTT DR
Mailing Address - Street 2:
Mailing Address - City:MONROE TWP
Mailing Address - State:NJ
Mailing Address - Zip Code:08831-3543
Mailing Address - Country:US
Mailing Address - Phone:917-207-6349
Mailing Address - Fax:718-431-8709
Practice Address - Street 1:10 SCOTT DR
Practice Address - Street 2:
Practice Address - City:MONROE TWP
Practice Address - State:NJ
Practice Address - Zip Code:08831-3543
Practice Address - Country:US
Practice Address - Phone:917-207-6349
Practice Address - Fax:718-431-8709
Is Sole Proprietor?:No
Enumeration Date:2015-03-24
Last Update Date:2015-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY695414-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse