Provider Demographics
NPI:1780174524
Name:CIERI, GHADA (CRNA/APN)
Entity type:Individual
Prefix:DR
First Name:GHADA
Middle Name:
Last Name:CIERI
Suffix:
Gender:F
Credentials:CRNA/APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 MARSHALL ST APT 502
Mailing Address - Street 2:
Mailing Address - City:HOBOKEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07030-7208
Mailing Address - Country:US
Mailing Address - Phone:862-452-6439
Mailing Address - Fax:
Practice Address - Street 1:30 B VREELAND ROAD
Practice Address - Street 2:SUITE 200
Practice Address - City:FLORHAM PARK
Practice Address - State:NJ
Practice Address - Zip Code:07932
Practice Address - Country:US
Practice Address - Phone:973-660-9334
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-17
Last Update Date:2019-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY647943-1163W00000X
NJ26NR14598200163W00000X
NJ26NJ00833000367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse