MS. CONSTANCE VICTORIA PROTENTIS (NPI# 1265921290) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265921290 |
| Entity Type | Individual |
| Full Name | MS. CONSTANCE VICTORIA PROTENTIS |
| Credential | PA-C |
| Practice Address |
1820 State Route 33 Ste 4b Neptune NJ 07753 |
| Mailing Address |
1820 State Route 33 Ste 4b Neptune NJ 07753-4860 |
| Practice Telephone | 7327768500 |
| Practice Fax Number | 7327768946 |
| Mailing Telephone | 7327768500 |
| Mailing Fax Number | 7327768946 |
| Enumeration Date | 2018-05-04 |
| Last Update Date | 2019-01-24 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
25MP00473500 | NJ | Physician Assistants & Advanced Practice Nursing Providers |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
1820 STATE ROUTE 33 STE 4B |
| City | NEPTUNE |
| State | NJ |
| Zip Code | 07753 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851370092 | Tony N Chu | Internal Medicine | 1820 State Route 33 Ste 4b, Neptune, NJ 07753-4860 | 2006-01-16 |
| 1922623115 | Dylan Mitchell Hagel | Physician Assistant | 1820 State Route 33 Ste 4b, Neptune, NJ 07753-4860 | 2020-06-12 |
| 1538793492 | Briana Mary Degraaf | Physician Assistant | 1820 State Route 33 Ste 4b, Neptune, NJ 07753-4860 | 2020-02-28 |
| 1285158147 | Arjun Swamy | Internal Medicine | 1820 State Route 33 Ste 4b, Neptune, NJ 07753-4860 | 2017-08-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255938361 | Maryjoy Marzan | Nurse Practitioner | Hope Tower - Jersey Shore University Medical Center, 19 Davis St 6th Floor, Neptune, NJ 07753 | 2020-10-02 |
| 1174138952 | Darlene Lupo | Nurse Practitioner | 72 Morris Ave, Neptune, NJ 07753 | 2020-09-09 |
| 1124645148 | Charlotte Emily Parker | Audiologist | 3700 Nj-33, Suite 101, Neptune City, NJ 07753 | 2020-06-26 |
| 1023667896 | Joseph Renninger | Psychologist | 2100 Route 33 Suite 9/10, Neptune, NJ 07753 | 2019-09-05 |
| 1952950800 | Matthew Aaron Brigle | Psychologist | 2100 Nj-33, Suite 9-10, Neptune City, NJ 07753 | 2019-09-04 |
| 1285292110 | Joseph F Mcnamara | Nurse Practitioner | 1945 Nj State Highway 33, Neptune, NJ 07753 | 2019-06-05 |
| 1679046601 | Richard Valderas Penalosa Jr. | Nurse Practitioner | 409 Locust St, Neptune, NJ 07753 | 2019-01-02 |
| 1528539822 | Neptune Rx LLC | Pharmacy | West Lake Pharmacy, 1828 West Lake Avenue, Neptune, NJ 07753 | 2018-12-12 |
| 1053880286 | Hmh Hospitals Corporation | Clinic/Center | 1200 Jumping Brook Rd., Bldg 5, Ste 201, Neptune, NJ 07753 | 2018-11-16 |
| 1972084424 | Melissa Hillebrecht | Psychologist | 2100 Nj-33 Suite 9-10, Neptune, NJ 07753 | 2018-08-23 |
| Find all providers in zip 07753 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073701819 | Parul M Kadakia | Physician Assistant | 2100 Corlies Ave Ste 12, Neptune, NJ 07753-6116 | 2007-10-05 |
| 1275589814 | Tania Uwais | Physician Assistant | 2100 State Route 33 Ste 15, Neptune, NJ 07753-6116 | 2006-05-25 |
| 1689121212 | Constance Petine | Physician Assistant | 1828 W Lake Ave, Neptune, NJ 07753-4663 | 2016-09-01 |
| 1558703744 | Nina M Chacko | Physician Assistant | 1532 Corlies Ave, Neptune, NJ 07753-4904 | 2013-07-29 |
| 1215215819 | Tammy Lynn Wood | Physician Assistant | 2100 Corlies Ave, Suite 12, Neptune, NJ 07753-6102 | 2011-07-30 |
| 1588703425 | Diane N Rosenthal | Physician Assistant | 1945 State Route 33, Ackerman 4 Trauma, Neptune, NJ 07753-4859 | 2007-02-06 |
| 1871543611 | Vincent Anthony Polizio | Physician Assistant | 26 Highway 35 N, Neptune, NJ 07753 | 2006-05-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891300612 | Heather C. Williamson | Physician Assistant | 57 Willis Dr, West Trenton, NJ 08628 | 2020-09-09 |
| 1427660810 | Lauren Colacicco | Physician Assistant | 406 Nj-23 North, Franklin, NJ 07416 | 2020-08-18 |
| 1912525353 | Thy T Pham | Physician Assistant | 2 Capital Way Ste 407, Pennington, NJ 08534-2521 | 2020-07-13 |
| 1982226270 | Alexandra Bellisario | Physician Assistant | 7 Normandy Pl, Colts Neck, NJ 07722-1174 | 2020-05-11 |
| 1497394266 | Trevor Paul | Physician Assistant | 167 Us Highway 9 Ste 5, Englishtown, NJ 07726-9215 | 2019-12-27 |
| 1295371003 | Sujin Kim | Physician Assistant | 500 Grand Ave Ste 201, Englewood, NJ 07631-4968 | 2019-11-27 |
| 1811531767 | Kaceyanne Lynn Cerankowski | Physician Assistant | 3131 Princeton Pike Bldg 4a, Lawrenceville, NJ 08648-2201 | 2019-11-04 |
| 1760024665 | Paula Kolodynski | Physician Assistant | 355 Us Route 22, Springfield Township, NJ 07081 | 2019-10-11 |
| 1245871334 | Terrell Amanda Collins | Physician Assistant | 76 W Jimmie Leeds Rd Ste 201, Galloway, NJ 08205-9417 | 2019-10-01 |
| 1013561422 | Adrienne Lauren Rinaldi | Physician Assistant | 1400 State Highway 70, Relievus, Cherry Hill, NJ 08034-0000 | 2019-07-25 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.