Basic Information
Provider Information
NPI: 1497211064
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ARCE
FirstName: DANA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: PNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 5 MULBERRY RD
Address2:  
City: TURNERSVILLE
State: NJ
PostalCode: 080122144
CountryCode: US
TelephoneNumber: 6097741767
FaxNumber:  
Practice Location
Address1: 1230 PARKWAY AVE STE 303
Address2:  
City: EWING
State: NJ
PostalCode: 086283018
CountryCode: US
TelephoneNumber: 6099899801
FaxNumber: 8887364821
Other Information
ProviderEnumerationDate: 02/19/2019
LastUpdateDate: 02/09/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 02/09/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LP0200X26NJ00912000NJY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics

No ID Information.


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