Provider Demographics
NPI:1558446815
Name:MENGARELLI, LAUREL MARIE (RN, CRNFA)
Entity Type:Individual
Prefix:MS
First Name:LAUREL
Middle Name:MARIE
Last Name:MENGARELLI
Suffix:
Gender:F
Credentials:RN, CRNFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:256 BEARWOODS RD
Mailing Address - Street 2:
Mailing Address - City:PARK RIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07656-2626
Mailing Address - Country:US
Mailing Address - Phone:201-825-1844
Mailing Address - Fax:
Practice Address - Street 1:256 BEARWOODS RD
Practice Address - Street 2:
Practice Address - City:PARK RIDGE
Practice Address - State:NJ
Practice Address - Zip Code:07656-2626
Practice Address - Country:US
Practice Address - Phone:201-825-1844
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-26
Last Update Date:2010-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR12313700163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ26NR12313700OtherREGISTERED NURSE
NY5734801OtherREGISTERED NURSE
CA312762OtherREGISTERED NURSE