Provider Demographics
NPI:1780979385
Name:GRZELAK VOLEZ, NOREEN (MED SPE ED)
Entity type:Individual
Prefix:
First Name:NOREEN
Middle Name:
Last Name:GRZELAK VOLEZ
Suffix:
Gender:F
Credentials:MED SPE ED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:455 COLONIAL TER
Mailing Address - Street 2:
Mailing Address - City:HACKENSACK
Mailing Address - State:NJ
Mailing Address - Zip Code:07601-1403
Mailing Address - Country:US
Mailing Address - Phone:201-996-9264
Mailing Address - Fax:
Practice Address - Street 1:455 COLONIAL TER
Practice Address - Street 2:
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601-1403
Practice Address - Country:US
Practice Address - Phone:201-996-9264
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-13
Last Update Date:2011-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ298033222Q00000X
NJ00302805174H00000X
NJ768842-298033174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist
No174H00000XOther Service ProvidersHealth Educator
No174400000XOther Service ProvidersSpecialist