Provider Demographics
NPI:1295773745
Name:FERLAZZO, HELEN (RN, APN, C ,ACRN)
Entity type:Individual
Prefix:MS
First Name:HELEN
Middle Name:
Last Name:FERLAZZO
Suffix:
Gender:F
Credentials:RN, APN, C ,ACRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1301 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ASBURY PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07712-5359
Mailing Address - Country:US
Mailing Address - Phone:732-774-6333
Mailing Address - Fax:732-774-8083
Practice Address - Street 1:1301 MAIN ST
Practice Address - Street 2:
Practice Address - City:ASBURY PARK
Practice Address - State:NJ
Practice Address - Zip Code:07712-5359
Practice Address - Country:US
Practice Address - Phone:732-774-6333
Practice Address - Fax:732-774-8083
Is Sole Proprietor?:No
Enumeration Date:2006-06-04
Last Update Date:2011-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00062400363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJQ20226Medicare UPIN
NJ081383Medicare ID - Type Unspecified