Individual
ARIELLE GANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
20 PROSPECT AVE, HACKENSACK, NJ 07601-1997
(551) 996-2608
(551) 996-0826
Mailing address
331 NEWMAN SPRINGS RD STE 220, RED BANK, NJ 07701-5688
(732) 807-0877
(201) 751-1680
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
742231
NY
363L00000X
Nurse Practitioner
Primary
26NJ14928700
NJ
363LF0000X
Family Nurse Practitioner
F352447
NY
Other
Enumeration date
09/28/2018
Last updated
05/24/2024
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