Healthcare Provider Details

I. General information

NPI: 1518447549
Provider Name (Legal Business Name): KRISTEN DENARO NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/20/2018
Last Update Date: 09/18/2026
Certification Date: 09/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 ROUTE 46 W
MOUNTAIN LAKES NJ
07046-1668
US

IV. Provider business mailing address

17 SANDERS RD
ROCKAWAY NJ
07866-2008
US

V. Phone/Fax

Practice location:
  • Phone: 862-832-2353
  • Fax: 855-710-7230
Mailing address:
  • Phone: 973-222-7636
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number26NJ00847700
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: