Healthcare Provider Details

I. General information

NPI: 1790644201
Provider Name (Legal Business Name): GABRIELA ANGELEINE FRIAS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/20/2026
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2110 OAK TREE RD
EDISON NJ
08820-1404
US

IV. Provider business mailing address

118 CLARK ST
ROSELLE NJ
07203-2505
US

V. Phone/Fax

Practice location:
  • Phone: 732-913-8500
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number26NJ15510300
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: