Basic Information
Provider Information
NPI: 1588303895
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ARRELUCEA
FirstName: KARINA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: PA
OtherOrganizationName:  
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Mailing Information
Address1: PO BOX 95000 LB#7550
Address2:  
City: PHILADELPHIA
State: PA
PostalCode: 191957550
CountryCode: US
TelephoneNumber: 8443621735
FaxNumber:  
Practice Location
Address1: 3175 NJ-10 BUILDING C
Address2: SUITE #500
City: DENVILLE
State: NJ
PostalCode: 07834
CountryCode: US
TelephoneNumber: 2013174590
FaxNumber: 9733432134
Other Information
ProviderEnumerationDate: 06/03/2022
LastUpdateDate: 10/31/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
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IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
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AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 10/26/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363A00000X NJY Physician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant 

No ID Information.


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