Provider Demographics
NPI:1992038699
Name:DEMARCO, CELESTE M (NP)
Entity type:Individual
Prefix:
First Name:CELESTE
Middle Name:M
Last Name:DEMARCO
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13 BLUEBERRY LN
Mailing Address - Street 2:
Mailing Address - City:TINTON FALLS
Mailing Address - State:NJ
Mailing Address - Zip Code:07724-9731
Mailing Address - Country:US
Mailing Address - Phone:732-859-2259
Mailing Address - Fax:732-542-3910
Practice Address - Street 1:385 TREMONT AVE
Practice Address - Street 2:
Practice Address - City:EAST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07018-1023
Practice Address - Country:US
Practice Address - Phone:732-859-2259
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-12
Last Update Date:2009-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH26NJ00194700363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health