Cassandra Lee Konecny, NP

Individual provider Active NPI Nurse Practitioner · Green Brook, NJ

NPI 1881243665 · NPPES record last updated Nov 4, 2019

Key facts

NPI
1881243665
Entity type
Individual (NPI type 1)
Primary specialty
Nurse Practitioner 363L00000X
License
26NJ00922500 (NJ)
Practice address
326 US Highway 22 Ste 10B
Green Brook, NJ 08812-1713
Phone
(732) 624-9797
NPI assigned
Sep 5, 2019
Sex
Female
Sole proprietor
Yes

Organizations & group practices 2

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Physician'S Weightloss, PC Single Specialty Past
since Sep 8, 2019
Accepting new patients
Bridgewater Health Associates Single Specialty Past
since Sep 8, 2019
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner
Group: 193400000X SINGLE SPECIALTY GROUP
363L00000X 26NJ00922500 NJ Yes

Addresses

Primary practice location

326 US Highway 22 Ste 10B
Green Brook, NJ 08812-1713

Mailing address

1 Capital Way
Pennington, NJ 08534-2520
Phone (609) 303-4000

Other providers in Green Brook, NJ

All providers in Green Brook, NJ · Nurse Practitioner in New Jersey

Sources for this page

Verify at the official NPI Registry.