Provider Demographics
NPI:1659102812
Name:VIDOJEVIKJ, VESNA (PMHNP-BC)
Entity type:Individual
Prefix:
First Name:VESNA
Middle Name:
Last Name:VIDOJEVIKJ
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:221 RIVER ST
Mailing Address - Street 2:
Mailing Address - City:HOBOKEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07030-5989
Mailing Address - Country:US
Mailing Address - Phone:201-256-7401
Mailing Address - Fax:
Practice Address - Street 1:221 RIVER ST STE 9
Practice Address - Street 2:
Practice Address - City:HOBOKEN
Practice Address - State:NJ
Practice Address - Zip Code:07030-5990
Practice Address - Country:US
Practice Address - Phone:201-256-7401
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-09
Last Update Date:2024-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ15106300363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health