Provider Demographics
NPI:1346640174
Name:OLAIREZ, HELEN DE LA CRUZ (APN)
Entity Type:Individual
Prefix:MRS
First Name:HELEN
Middle Name:DE LA CRUZ
Last Name:OLAIREZ
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:HELEN
Other - Middle Name:CALPOTURA
Other - Last Name:DE LA CRUZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:210 JACK MARTIN BLVD
Mailing Address - Street 2:
Mailing Address - City:BRICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08724-7771
Mailing Address - Country:US
Mailing Address - Phone:732-458-5067
Mailing Address - Fax:732-458-4962
Practice Address - Street 1:210 JACK MARTIN BLVD
Practice Address - Street 2:
Practice Address - City:BRICK
Practice Address - State:NJ
Practice Address - Zip Code:08724-7771
Practice Address - Country:US
Practice Address - Phone:732-458-5067
Practice Address - Fax:732-458-4962
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-28
Last Update Date:2014-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00517700363LA2200X, 363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology