Healthcare Provider Details

I. General information

NPI: 1720182934
Provider Name (Legal Business Name): ANRELA VITUG GADIA NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/08/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

151 KNOLLCROFT ROAD
LYONS NJ
07939
US

IV. Provider business mailing address

2462 TERRILL RD
UNION NJ
07939
US

V. Phone/Fax

Practice location:
  • Phone: 908-647-0180
  • Fax: 908-607-6367
Mailing address:
  • Phone: 908-688-7116
  • Fax: 908-607-6367

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number26N009380200
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: