Healthcare Provider Details

I. General information

NPI: 1619856226
Provider Name (Legal Business Name): ARIELLA REBECCAH GROSSMAN FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/28/2025
Last Update Date: 08/28/2025
Certification Date: 08/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6 FOREST AVE STE 202
PARAMUS NJ
07652-5245
US

IV. Provider business mailing address

962 QUEEN ANNE RD
TEANECK NJ
07666-4626
US

V. Phone/Fax

Practice location:
  • Phone: 201-381-3810
  • Fax:
Mailing address:
  • Phone: 201-838-2493
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number26NJ01459400
License Number StateNJ

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: