Provider Demographics
NPI:1427063940
Name:PENEIRAS, DEBRA (PMHNP-BC)
Entity type:Individual
Prefix:
First Name:DEBRA
Middle Name:
Last Name:PENEIRAS
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 BUNKER HILL RD
Mailing Address - Street 2:
Mailing Address - City:FREEHOLD
Mailing Address - State:NJ
Mailing Address - Zip Code:07728-1381
Mailing Address - Country:US
Mailing Address - Phone:732-687-5644
Mailing Address - Fax:732-410-4640
Practice Address - Street 1:660 TENNENT RD STE 102
Practice Address - Street 2:
Practice Address - City:MANALAPAN
Practice Address - State:NJ
Practice Address - Zip Code:07726-3163
Practice Address - Country:US
Practice Address - Phone:732-993-3398
Practice Address - Fax:732-719-2108
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-31
Last Update Date:2025-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NN11373400363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8499209Medicaid
NJP16131Medicare UPIN
NJ043091Medicare ID - Type Unspecified