Individual provider Active NPI

Evelyn Tashjian Ambrose, ADVANCE PRACTICE NUR

  • Adult Health Clinical Nurse Specialist
  • Newark, NJ
National Provider Identifier
1891969374
Registry record updated Apr 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Clinical Nurse SpecialistTaxonomy code 364SA2200X
License
26NN02749100 Issued in NJ
Practice address
249 University Ave
Rutgers University Health Services RM 104
Newark, NJ 07102-1808
Phone
(973) 353-5231
Fax
(973) 353-1390
NPI assigned
Apr 16, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Clinical Nurse Specialist 364SA2200X 26NN02749100 NJ Primary

Addresses

Primary practice location

249 University Ave
Rutgers University Health Services RM 104
Newark, NJ 07102-1808

Mailing address

249 University Ave
Rutgers University Health Services RM 104
Newark, NJ 07102-1808
Phone (973) 353-5231

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
26NN02749100NJMDAdult Health Clinical Nurse Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Rutgers Newark Campus Pharmacy Past Accepting new patients

Organizations & group practices 1

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": "1208304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208304000000",
    "number": "1891969374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "249 UNIVERSITY AVE",
            "address_2": "RUTGERS UNIVERSITY HEALTH SERVICES RM 104",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071021808",
            "telephone_number": "973-353-5231",
            "fax_number": "973-353-1390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "249 UNIVERSITY AVE",
            "address_2": "RUTGERS UNIVERSITY HEALTH SERVICES RM 104",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071021808",
            "telephone_number": "973-353-5231",
            "fax_number": "973-353-1390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMBROSE",
        "first_name": "EVELYN",
        "middle_name": "TASHJIAN",
        "credential": "ADVANCE PRACTICE NUR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-16",
        "last_updated": "2008-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SA2200X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Adult Health",
            "state": "NJ",
            "license": "26NN02749100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.