Healthcare Provider Details

I. General information

NPI: 1760074199
Provider Name (Legal Business Name): NICOLE PERRUCCI APN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: NICOLE PERRUCCI APN

II. Dates (important events)

Enumeration Date: 02/08/2021
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 MADISON AVE FL 2
MORRISTOWN NJ
07960-7337
US

IV. Provider business mailing address

PO BOX 416457
BOSTON MA
02241-6457
US

V. Phone/Fax

Practice location:
  • Phone: 973-971-5700
  • Fax: 973-290-7417
Mailing address:
  • Phone: 844-362-1735
  • Fax: 973-290-7495

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number26NJ01096000
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: