Provider Demographics
NPI:1760078893
Name:HARULAJ, ADRIANNA
Entity Type:Individual
Prefix:
First Name:ADRIANNA
Middle Name:
Last Name:HARULAJ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9252 KENNEDY BLVD APT 405
Mailing Address - Street 2:
Mailing Address - City:NORTH BERGEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07047-9300
Mailing Address - Country:US
Mailing Address - Phone:973-525-0864
Mailing Address - Fax:
Practice Address - Street 1:9252 KENNEDY BLVD APT 405
Practice Address - Street 2:
Practice Address - City:NORTH BERGEN
Practice Address - State:NJ
Practice Address - Zip Code:07047-9300
Practice Address - Country:US
Practice Address - Phone:973-525-0864
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-13
Last Update Date:2020-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ01073200363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0000000000Medicaid