Active NPI
Christina Eadicicco
- Psychiatric/Mental Health Nurse Practitioner
- Sicklerville, NJ
National Provider Identifier
1093478067
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- 26NJ01217400
- Practice address
- 1108 Elena CT
Sicklerville, NJ 08081-1108 - Phone
- (856) 278-9539
- NPI assigned
- Oct 18, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 26NJ01217400 | NJ | Primary |
Addresses
Primary practice location
1108 Elena CT
Sicklerville, NJ 08081-1108
Mailing address
1108 Elena CT
Sicklerville, NJ 08081-1108
Phone (856) 278-9539
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 26NJ01217400 | NJ | MD | Psychiatric/Mental Health Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1634515200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1634515200000",
"number": "1093478067",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1108 ELENA CT",
"city": "SICKLERVILLE",
"state": "NJ",
"postal_code": "080811108",
"telephone_number": "856-278-9539"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1108 ELENA CT",
"city": "SICKLERVILLE",
"state": "NJ",
"postal_code": "080811108",
"telephone_number": "856-278-9539"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EADICICCO",
"first_name": "CHRISTINA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-10-18",
"last_updated": "2021-10-18",
"certification_date": "2021-10-14",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "NJ",
"license": "26NJ01217400",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sicklerville, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.