Healthcare Provider Details

I. General information

NPI: 1841908282
Provider Name (Legal Business Name): HALYNA HUSAK AGNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/14/2022
Last Update Date: 09/20/2025
Certification Date: 09/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

240 E GROVE ST
WESTFIELD NJ
07090-1687
US

IV. Provider business mailing address

240 E GROVE ST
WESTFIELD NJ
07090-1687
US

V. Phone/Fax

Practice location:
  • Phone: 908-232-6446
  • Fax:
Mailing address:
  • Phone: 908-232-6446
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number26NJ01428300
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: