Provider Demographics
NPI:1619379641
Name:GREULICH, FELICIA (APN)
Entity Type:Individual
Prefix:
First Name:FELICIA
Middle Name:
Last Name:GREULICH
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:FELICIA
Other - Middle Name:
Other - Last Name:GREULICH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:APN
Mailing Address - Street 1:34 BEEKMAN RD
Mailing Address - Street 2:
Mailing Address - City:BRIDGEWATER
Mailing Address - State:NJ
Mailing Address - Zip Code:08807-2625
Mailing Address - Country:US
Mailing Address - Phone:973-467-0610
Mailing Address - Fax:
Practice Address - Street 1:16 POMPTON AVE
Practice Address - Street 2:
Practice Address - City:POMPTON LAKES
Practice Address - State:NJ
Practice Address - Zip Code:07442-1895
Practice Address - Country:US
Practice Address - Phone:973-831-6866
Practice Address - Fax:973-831-9639
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-22
Last Update Date:2021-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00520600363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily