Healthcare Provider Details

I. General information

NPI: 1215856133
Provider Name (Legal Business Name): BIANCA SANON NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2026
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 CLARA MAASS DR
BELLEVILLE NJ
07109-3550
US

IV. Provider business mailing address

26 MERTZ AVE
HILLSIDE NJ
07205-1609
US

V. Phone/Fax

Practice location:
  • Phone: 973-450-2000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number408913
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: