Provider Demographics
NPI:1841908282
Name:HUSAK, HALYNA (AGNP)
Entity type:Individual
Prefix:
First Name:HALYNA
Middle Name:
Last Name:HUSAK
Suffix:
Gender:F
Credentials:AGNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:170 NEWMAN ST
Mailing Address - Street 2:
Mailing Address - City:METUCHEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08840-2642
Mailing Address - Country:US
Mailing Address - Phone:862-215-6654
Mailing Address - Fax:
Practice Address - Street 1:170 NEWMAN ST
Practice Address - Street 2:
Practice Address - City:METUCHEN
Practice Address - State:NJ
Practice Address - Zip Code:08840-2642
Practice Address - Country:US
Practice Address - Phone:862-215-6654
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-14
Last Update Date:2023-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11022798363L00000X
NJ26NJ01428300363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner