Provider Demographics
NPI:1962899658
Name:SCIRIA, JENNIFER (APN-C)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:
Last Name:SCIRIA
Suffix:
Gender:F
Credentials:APN-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 BOBBY JONES CT
Mailing Address - Street 2:
Mailing Address - City:FARMINGDALE
Mailing Address - State:NJ
Mailing Address - Zip Code:07727-3868
Mailing Address - Country:US
Mailing Address - Phone:732-687-2210
Mailing Address - Fax:
Practice Address - Street 1:333 FORSGATE DR
Practice Address - Street 2:SUITE 205
Practice Address - City:JAMESBURG
Practice Address - State:NJ
Practice Address - Zip Code:08831-1567
Practice Address - Country:US
Practice Address - Phone:732-521-1210
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-20
Last Update Date:2015-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00564200363LA2200X, 363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology