Healthcare Provider Details

I. General information

NPI: 1093726697
Provider Name (Legal Business Name): ELIZABETH ANNE BELLA APN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/10/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6 FRANKLIN RD
MENDHAM NJ
07945-1808
US

IV. Provider business mailing address

6 FRANKLIN RD
MENDHAM NJ
07945-1808
US

V. Phone/Fax

Practice location:
  • Phone: 973-543-8877
  • Fax:
Mailing address:
  • Phone: 973-543-8877
  • Fax: 973-543-5199

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number26NJ00008400
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: