Provider Demographics
NPI:1871359828
Name:CAESAR-ANGUS, ALEXIS VERONICA
Entity type:Individual
Prefix:
First Name:ALEXIS
Middle Name:VERONICA
Last Name:CAESAR-ANGUS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:357 LINCOLN AVENUE
Mailing Address - Street 2:APT 3E
Mailing Address - City:ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07050
Mailing Address - Country:US
Mailing Address - Phone:862-253-8956
Mailing Address - Fax:
Practice Address - Street 1:357 LINCOLN AVENUE
Practice Address - Street 2:APT 3E
Practice Address - City:ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07050
Practice Address - Country:US
Practice Address - Phone:862-253-8956
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-27
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NP06341100164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse