Individual
BRYAN BOLANOSGONZALEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
429-4 STATE ROUTE 31 S, WASHINGTON, NJ 07882-4182
(908) 271-8368
Mailing address
26 JOURNAL SQ, JERSEY CITY, NJ 07306-4102
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
26NR19503300
NJ
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
26NJ15345000
NJ
Other
Enumeration date
09/05/2024
Last updated
08/27/2025
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