Healthcare Provider Details

I. General information

NPI: 1841089554
Provider Name (Legal Business Name): BRIANA NICOLE BALDANZA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/01/2025
Last Update Date: 05/01/2025
Certification Date: 05/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

270 OLD HOOK RD STE 2
WESTWOOD NJ
07675-3118
US

IV. Provider business mailing address

533 RATZER RD
WAYNE NJ
07470-4102
US

V. Phone/Fax

Practice location:
  • Phone: 201-358-0505
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number26NJ15270900
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: