=====================================================
General NPI Number Information
=====================================================
NPI Number | 1407026248
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | LUIS A. FEBUS NP
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/07/2008
-----------------------------------------------------
Last Update Date | 11/20/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 99 GORGE RD APT 1908
-----------------------------------------------------
City | EDGEWATER
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07020-1726
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 201-464-6147
-----------------------------------------------------
Fax | 201-462-3899
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 99 GORGE RD APT 1908
-----------------------------------------------------
City | EDGEWATER
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07020-1726
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 201-464-6147
-----------------------------------------------------
Fax | 201-462-3899
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LA2200X
-----------------------------------------------------
Taxonomy Name | Adult Health Nurse Practitioner
-----------------------------------------------------
License Number | 26NJ00151600
-----------------------------------------------------
License Number State | NJ
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 363LP0808X
-----------------------------------------------------
Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
-----------------------------------------------------
License Number | 26NJ00151600
-----------------------------------------------------
License Number State | NJ
-----------------------------------------------------