Provider Demographics
NPI:1487731139
Name:CZENIS, AMY (APN)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:CZENIS
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 1:876 WESTMINSTER DR
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08753-4474
Mailing Address - Country:US
Mailing Address - Phone:732-288-0383
Mailing Address - Fax:609-261-7199
Practice Address - Street 1:8025 BLACK HORSE PIKE STE 501
Practice Address - Street 2:
Practice Address - City:PLEASANTVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08232-2967
Practice Address - Country:US
Practice Address - Phone:844-929-0225
Practice Address - Fax:609-822-7980
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2024-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NO09756900363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
2196326000OtherAMERIHEALTH/KEYSTONE/PC
NJ500017915OtherRAILROAD MEDICARE
NJ033645Medicare ID - Type Unspecified