Mary Rose Boutros, AGNP
Nurse Practitioner, Gerontology in Tinton Falls, New Jersey
1285116822- Practice location
- 22 Topeka CT, Tinton Falls, NJ 07712-7508
- Phone
- 732-618-7718
- Fax
- —
- Last updated
- April 21, 2026
Mary Rose Boutros is a Nurse Practitioner, Gerontology based in Tinton Falls, NJ. Mary Rose Boutros practices in Tinton Falls, NJ and has the professional credentials of AGNP. The NPI Number for Mary Rose Boutros is 1285116822 and holds a License No. 26NJ00851300 (NJ). The current practice location address for Mary Rose Boutros is 22 Topeka CT, Tinton Falls, NJ 07712-7508 and can be reached out via phone at 732-618-7718.
Provider Profile Details
- NPI Number
- 1285116822
- Provider Name
- Mary Rose Boutros
- Credential
- AGNP
- Provider Entity Type
- Individual
- Gender
- Female
- Address
- 22 Topeka CT, Tinton Falls, NJ 07712-7508
- Phone Number
- 732-618-7718
- Primary Taxonomy
- Nurse Practitioner, Gerontology · 363LG0600X
- Sole Proprietor
- No
- Provider Enumeration Date
- August 30, 2018
- Last Update Date
- April 21, 2026
- Certification Date
- April 21, 2026
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 22 Topeka CT
Tinton Falls, NJ 07712-7508 - City
- Tinton Falls
- State
- New Jersey
- Zip
- 07712-7508
- Phone Number
- 732-618-7718
Provider Business Mailing Address Details
- Address
- 22 Topeka CT
Tinton Falls, NJ 07712-7508 - City
- Tinton Falls
- State
- NJ
- Zip
- 07712-7508
- Phone Number
- 732-618-7718
License Information
- License Number (1)
- 26NJ00851300
- License State (1)
- NJ
- Taxonomy (1)
- Nurse Practitioner, Gerontology · 363LG0600X · Primary
- License Number (2)
- 26NJ00851300
- License State (2)
- NJ
- Taxonomy (2)
- Nurse Practitioner, Adult Health · 363LA2200X
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
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Frequently Asked Questions
What is the NPI number of Mary Rose Boutros, AGNP?
The NPI number of Mary Rose Boutros, AGNP is 1285116822. It was assigned on August 30, 2018 and is currently active in the NPPES registry.
What is the specialty of Mary Rose Boutros, AGNP?
Mary Rose Boutros, AGNP is registered under the primary taxonomy Nurse Practitioner, Gerontology (code 363LG0600X), licensed in NJ under license number 26NJ00851300.
Where does Mary Rose Boutros, AGNP practice?
The practice location is 22 Topeka CT, Tinton Falls, NJ 07712-7508. The office can be reached at 732-618-7718 (phone).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1285116822 directly on the NPPES registry website.