Provider Demographics
NPI:1356708812
Name:KULIK, GABRIELLE N (APN)
Entity type:Individual
Prefix:
First Name:GABRIELLE
Middle Name:N
Last Name:KULIK
Suffix:
Gender:
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 WANAQUE AVE
Mailing Address - Street 2:
Mailing Address - City:POMPTON LAKES
Mailing Address - State:NJ
Mailing Address - Zip Code:07442
Mailing Address - Country:US
Mailing Address - Phone:973-617-1750
Mailing Address - Fax:973-617-1751
Practice Address - Street 1:17 WANAQUE AVE
Practice Address - Street 2:
Practice Address - City:POMPTON LAKES
Practice Address - State:NJ
Practice Address - Zip Code:07442
Practice Address - Country:US
Practice Address - Phone:973-617-1750
Practice Address - Fax:973-617-1751
Is Sole Proprietor?:No
Enumeration Date:2016-01-28
Last Update Date:2025-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00529300363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily