MEDICARE: ALISON R GROLLI

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	26NJ14966500	NJ
2	363LF0000X	Family Nurse Practitioner	F352754-01	NY

General Provider Information

NPI Number	:	1972364768
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALISON R GROLLI

Provider Business Mailing Address
First Line	:	53 BOILING SPRINGS AVE
Second Line	:
City	:	EAST RUTHERFORD
State	:	NJ
Zip	:	07073-1430
Country	:	US
Telephone Number	:	201-637-2108
Fax Number	:

Provider Business Practice Location Address
First Line	:	22 SYLVAN ST STE 200
Second Line	:
City	:	RUTHERFORD
State	:	NJ
Zip	:	07070-2087
Country	:	US
Telephone Number	:	551-364-2852
Fax Number	:	551-381-0150

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/18/2024
Last Update Date	:	12/02/2025

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Directions to “ ALISON R GROLLI ” Practice Location

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