Individual provider Active NPI

Laura E Ciavolino, APN, BC

  • Nurse Practitioner
  • Long Branch, NJ
National Provider Identifier
1235317108
Registry record updated Sep 23, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
26NJ00064300 Issued in NJ
Practice address
300 2ND Ave
Long Branch, NJ 07740-6303
Phone
(732) 923-6569
Fax
(732) 923-7724
NPI assigned
Feb 4, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 23, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 26NJ00064300 NJ Primary

Addresses

Primary practice location

300 2ND Ave
Long Branch, NJ 07740-6303

Mailing address

300 2ND Ave
Long Branch, NJ 07740-6303
Phone (732) 923-6569

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100105000383 NJ Practitioner - Nurse Practitioner 6406997030 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
26NJ00064300NJMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Rutgers Health-RWJ Primary Medicine Group Current Accepting new patients
Rutgers Health-RWJ Scleroderma Program Current Accepting new patients
Rutgers Health-RWJ Scleroderma Program CurrentSince Feb 1, 2021 Accepting new patients
Rutgers Health-RWJ Scleroderma Program CurrentSince Feb 1, 2021 Accepting new patients
Robert Wood Johnson Medical Associates CurrentSince Mar 30, 2019 Accepting new patients
Rutgers Health-RWJ Scleroderma Program Current Accepting new patients

Locations

300 2nd Ave
Long Branch, NJ 07740
Phone (732) 222-5200

195 Little Albany St
New Brunswick, NJ 08901
Phone (732) 235-2465

1 Rwj Pl
New Brunswick, NJ 08901
Phone (732) 235-7887

125 Paterson St
Ste 5100
New Brunswick, NJ 08901
Phone (732) 235-7060

125 Paterson St
Ste 6100
New Brunswick, NJ 08901
Phone (732) 235-6561

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1202083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1253664000000",
    "number": "1235317108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 2ND AVE",
            "city": "LONG BRANCH",
            "state": "NJ",
            "postal_code": "077406303",
            "telephone_number": "732-923-6569",
            "fax_number": "732-923-7724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 2ND AVE",
            "city": "LONG BRANCH",
            "state": "NJ",
            "postal_code": "077406303",
            "telephone_number": "732-923-6569",
            "fax_number": "732-923-7724"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CIAVOLINO",
        "first_name": "LAURA",
        "middle_name": "E",
        "credential": "APN, BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-02-04",
        "last_updated": "2009-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NJ",
            "license": "26NJ00064300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Branch, NJ

Sources for this page

Verify at the official NPI Registry.