Provider Demographics
NPI:1891678892
Name:LOCKLEAR, ITOHAN CINDY (APN)
Entity type:Individual
Prefix:
First Name:ITOHAN CINDY
Middle Name:
Last Name:LOCKLEAR
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:56 AVENUE H
Mailing Address - Street 2:
Mailing Address - City:MONROE TOWNSHIP
Mailing Address - State:NJ
Mailing Address - Zip Code:08831-2152
Mailing Address - Country:US
Mailing Address - Phone:973-953-3311
Mailing Address - Fax:
Practice Address - Street 1:105 JOYCE KILMER AVE
Practice Address - Street 2:
Practice Address - City:NEW BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08901-2915
Practice Address - Country:US
Practice Address - Phone:732-828-6002
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-28
Last Update Date:2025-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ15367000363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily