Provider Demographics
NPI:1528289279
Name:VERMEULEN, ERIN LYNNE (PA - C)
Entity type:Individual
Prefix:MRS
First Name:ERIN
Middle Name:LYNNE
Last Name:VERMEULEN
Suffix:
Gender:F
Credentials:PA - C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:13 TAMARACK RD
Mailing Address - Street 2:
Mailing Address - City:BUDD LAKE
Mailing Address - State:NJ
Mailing Address - Zip Code:07828
Mailing Address - Country:US
Mailing Address - Phone:973-347-1065
Mailing Address - Fax:973-691-8990
Practice Address - Street 1:SAINT BARNABAS MEDICAL CENTER
Practice Address - Street 2:94 OLD SHORT HILLS RD
Practice Address - City:LIVINGSTON
Practice Address - State:NJ
Practice Address - Zip Code:07039
Practice Address - Country:US
Practice Address - Phone:973-322-5195
Practice Address - Fax:973-322-2471
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MP00001600363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical