Healthcare Provider Details

I. General information

NPI: 1508797440
Provider Name (Legal Business Name): NICOLE ANN PAPALIA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/28/2026
Last Update Date: 05/28/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 NJ-35 SUITE 512
RED BANK NJ
07701
US

IV. Provider business mailing address

6 MAPLE LEAF DR
HOLMDEL NJ
07733-2924
US

V. Phone/Fax

Practice location:
  • Phone: 732-333-1355
  • Fax:
Mailing address:
  • Phone: 732-228-1985
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberTL-5031
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: