Provider Demographics
NPI:1942040662
Name:VITA NOVA SANA NP IN PSYCHIATRY
Entity type:Organization
Organization Name:VITA NOVA SANA NP IN PSYCHIATRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CASSANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:NUNEZ
Authorized Official - Suffix:
Authorized Official - Credentials:DNP FNP-BC PMHNP-BC
Authorized Official - Phone:646-847-8654
Mailing Address - Street 1:180 TALMADGE RD # 822
Mailing Address - Street 2:
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08817-2860
Mailing Address - Country:US
Mailing Address - Phone:646-847-8654
Mailing Address - Fax:973-604-4174
Practice Address - Street 1:180 TALMADGE RD # 822
Practice Address - Street 2:
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08817-2860
Practice Address - Country:US
Practice Address - Phone:646-847-8654
Practice Address - Fax:973-604-4174
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-30
Last Update Date:2024-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty