Provider Demographics
NPI:1124679725
Name:MANGALONZO, APRILLE PALAC (RN, MSN, PMHNP-BC)
Entity type:Individual
Prefix:MS
First Name:APRILLE
Middle Name:PALAC
Last Name:MANGALONZO
Suffix:
Gender:F
Credentials:RN, MSN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 HILLCREST BLVD
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:NJ
Mailing Address - Zip Code:07059-5116
Mailing Address - Country:US
Mailing Address - Phone:908-304-2905
Mailing Address - Fax:
Practice Address - Street 1:14 HILLCREST BLVD
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:NJ
Practice Address - Zip Code:07059-5116
Practice Address - Country:US
Practice Address - Phone:908-304-2905
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-25
Last Update Date:2019-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY402738363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health