Provider Demographics
NPI:1538509708
Name:CIACCIARELLI, ELLEN M (RN, MS, APN-C)
Entity Type:Individual
Prefix:MRS
First Name:ELLEN
Middle Name:M
Last Name:CIACCIARELLI
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Gender:F
Credentials:RN, MS, APN-C
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Mailing Address - Street 1:901 W MAIN ST
Mailing Address - Street 2:BUILDING B SUITE 106
Mailing Address - City:FREEHOLD
Mailing Address - State:NJ
Mailing Address - Zip Code:07728-2537
Mailing Address - Country:US
Mailing Address - Phone:732-367-6366
Mailing Address - Fax:732-780-3012
Practice Address - Street 1:901 W MAIN ST
Practice Address - Street 2:BUILDING B SUITE 106
Practice Address - City:FREEHOLD
Practice Address - State:NJ
Practice Address - Zip Code:07728-2537
Practice Address - Country:US
Practice Address - Phone:732-367-6366
Practice Address - Fax:732-780-3012
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-02
Last Update Date:2013-07-02
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Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00446000363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care