Healthcare Provider Details

I. General information

NPI: 1811826894
Provider Name (Legal Business Name): DANA RUPNARAIN-HEDLUND
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/15/2026
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

36 VILLAGE CT
HAZLET NJ
07730-1534
US

IV. Provider business mailing address

410 HARMONY RD
MIDDLETOWN NJ
07748-1129
US

V. Phone/Fax

Practice location:
  • Phone: 732-945-8800
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF359318-01
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number26NJ15590300
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: