Healthcare Provider Details

I. General information

NPI: 1215288972
Provider Name (Legal Business Name): HALINA ZABORNIAK APN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2012
Last Update Date: 09/19/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

741 BROADWAY
NEWARK NJ
07104
US

IV. Provider business mailing address

19 SAVAGE RD APT A1
DENVILLE NJ
07834-1616
US

V. Phone/Fax

Practice location:
  • Phone: 201-675-1900
  • Fax: 973-676-1396
Mailing address:
  • Phone: 973-590-6921
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number26NJ00797100
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: