Healthcare Provider Details

I. General information

NPI: 1508577479
Provider Name (Legal Business Name): CRISTINA MARIE FICARRA APN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/12/2022
Last Update Date: 03/23/2026
Certification Date: 03/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

92 2ND ST
HACKENSACK NJ
07601-2191
US

IV. Provider business mailing address

61 CRESTWOOD AVE
BELLEVILLE NJ
07109-1513
US

V. Phone/Fax

Practice location:
  • Phone: 551-996-2000
  • Fax:
Mailing address:
  • Phone: 551-655-3215
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number26NJ01409500
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number26NJ01409500
License Number StateNJ
# 3
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number26NJ01409500
License Number StateNJ
# 4
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number26NJ01409500
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: