Individual provider · Type 1 NPI
Bryan Bolanosgonzalez
Psychiatric/Mental Health Nurse Practitioner · Paramus, NJ
NPI number
1689409054
Active
Practice location
16 Arcadian Way Ste C2
Paramus, NJ 07652-1291
Mailing address
429-4 State Route 31 S
Washington, NJ 07882-4182
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Registered Nurse | 163W00000X | 26NR19503300 (NJ) |
| Psychiatric/Mental Health Nurse Practitioner Primary | 363LP0808X | 26NJ15345000 (NJ) |
Psychiatric/Mental Health Nurse Practitioner: Definition to come...
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About NPI 1689409054
Bryan Bolanosgonzalez's National Provider Identifier is 1689409054, issued on Sep 5, 2024. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Paramus, NJ. The record was last updated on Jun 29, 2026.