Healthcare Provider Details

I. General information

NPI: 1942016860
Provider Name (Legal Business Name): LAURA HELEWA FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/05/2024
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

240 PARK AVE
RUTHERFORD NJ
07070-2323
US

IV. Provider business mailing address

479 GRANDVIEW AVE
WYCKOFF NJ
07481-2543
US

V. Phone/Fax

Practice location:
  • Phone: 551-309-3555
  • Fax: 833-775-0075
Mailing address:
  • Phone: 201-660-5996
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number26NJ15185500
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: