Provider Demographics
NPI:1801067590
Name:GULIK, ANNA MARIA (NURSE PRACTITIONER)
Entity type:Individual
Prefix:MRS
First Name:ANNA
Middle Name:MARIA
Last Name:GULIK
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 SHORT GRASS PL
Mailing Address - Street 2:
Mailing Address - City:HAMBURG
Mailing Address - State:NJ
Mailing Address - Zip Code:07419-2504
Mailing Address - Country:US
Mailing Address - Phone:973-204-4546
Mailing Address - Fax:
Practice Address - Street 1:400 W BLACKWELL ST
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:NJ
Practice Address - Zip Code:07801-2525
Practice Address - Country:US
Practice Address - Phone:973-989-3085
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-20
Last Update Date:2008-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00135900363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health