Provider Demographics
NPI:1619856226
Name:GROSSMAN, ARIELLA REBECCAH (FNP-C)
Entity type:Individual
Prefix:
First Name:ARIELLA
Middle Name:REBECCAH
Last Name:GROSSMAN
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:962 QUEEN ANNE RD
Mailing Address - Street 2:
Mailing Address - City:TEANECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07666-4626
Mailing Address - Country:US
Mailing Address - Phone:201-838-2493
Mailing Address - Fax:
Practice Address - Street 1:6 FOREST AVE STE 202
Practice Address - Street 2:
Practice Address - City:PARAMUS
Practice Address - State:NJ
Practice Address - Zip Code:07652-5245
Practice Address - Country:US
Practice Address - Phone:201-381-3810
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-28
Last Update Date:2025-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ01459400363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner