Doctor Name: | RISHA JAMES HERTZ |
NPI Number: | 1457783607 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CRNP |
License Number: | 26NJ00435800 |
Business Practice Address: | 63 N Lakeview Dr Bldg. B, Ste. 201 Gibbsboro, NJ - 080261026 |
Business Phone Number: | 8567831777 |
Business Fax Number: | |
Mailing Address: | 63 N Lakeview Dr, Bldg. B, Ste. 201 GIBBSBORO |
State: | NJ |
Postal Code: | 080261026 |
Phone Number: | 8567831777 |
Fax Number: | |
NPI Enumeration Date: | 07/30/2013 |
NPI Last Update Date: | 07/30/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LG0600X |
License Number: | 26NJ00435800 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NJ |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Gerontology |
Taxonomy Definition: |