Healthcare Provider Details

I. General information

NPI: 1497771000
Provider Name (Legal Business Name): CATHERINE LYNN PELLERANO RN, NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CATHERINE LYNN MULLER RN, NP

II. Dates (important events)

Enumeration Date: 07/15/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

385 TREMONT AVE
EAST ORANGE NJ
07018-1023
US

IV. Provider business mailing address

641 DRAKE PL
WESTFIELD NJ
07090-4159
US

V. Phone/Fax

Practice location:
  • Phone: 973-676-1000
  • Fax:
Mailing address:
  • Phone: 908-654-7209
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number26NN10628000
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: