Healthcare Provider Details

I. General information

NPI: 1992682579
Provider Name (Legal Business Name): ALEXA JOAN COZZARELLI BSN, RN, CV-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/18/2025
Last Update Date: 08/18/2025
Certification Date: 08/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

65 BERGEN ST
NEWARK NJ
07107-3001
US

IV. Provider business mailing address

5 STERLING CT
WHIPPANY NJ
07981-2000
US

V. Phone/Fax

Practice location:
  • Phone: 201-919-1736
  • Fax:
Mailing address:
  • Phone: 201-919-1736
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License Number26NR22334500
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: