Provider Demographics
NPI:1275348914
Name:FUNICELLI, SHARON (DNP,RN APRN FNP-BC)
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:
Last Name:FUNICELLI
Suffix:
Gender:F
Credentials:DNP,RN APRN FNP-BC
Other - Prefix:
Other - First Name:SHARON
Other - Middle Name:
Other - Last Name:FUNICELLI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DNP,RN APRN FNP-BC
Mailing Address - Street 1:182 S NEW YORK RD
Mailing Address - Street 2:
Mailing Address - City:GALLOWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:08205-9786
Mailing Address - Country:US
Mailing Address - Phone:609-748-8200
Mailing Address - Fax:
Practice Address - Street 1:182 S NEW YORK RD
Practice Address - Street 2:
Practice Address - City:GALLOWAY
Practice Address - State:NJ
Practice Address - Zip Code:08205-9786
Practice Address - Country:US
Practice Address - Phone:609-748-8200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-10
Last Update Date:2025-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ15264500363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care