Healthcare Provider Details

I. General information

NPI: 1295773745
Provider Name (Legal Business Name): HELEN FERLAZZO RN, APN, C. ,ACRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/04/2006
Last Update Date: 11/29/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 MAIN ST
ASBURY PARK NJ
07712-5359
US

IV. Provider business mailing address

1301 MAIN ST
ASBURY PARK NJ
07712-5359
US

V. Phone/Fax

Practice location:
  • Phone: 732-774-6333
  • Fax: 732-774-8083
Mailing address:
  • Phone: 732-774-6333
  • Fax: 732-774-8083

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number26NJ00062400
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: