Provider Demographics
NPI:1356140628
Name:TERUEL, ANTONIO E (AGPCNP-C)
Entity type:Individual
Prefix:
First Name:ANTONIO
Middle Name:E
Last Name:TERUEL
Suffix:
Gender:M
Credentials:AGPCNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:655 AMBOY AVE STE 403
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07095-3145
Mailing Address - Country:US
Mailing Address - Phone:732-874-7888
Mailing Address - Fax:
Practice Address - Street 1:655 AMBOY AVE STE 403
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:NJ
Practice Address - Zip Code:07095-3145
Practice Address - Country:US
Practice Address - Phone:732-874-7888
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-10
Last Update Date:2025-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ15281800363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner