Provider Demographics
NPI:1053959544
Name:HOLLANDER, AHUVA (CPNP)
Entity type:Individual
Prefix:
First Name:AHUVA
Middle Name:
Last Name:HOLLANDER
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:
Other - First Name:YURTZA
Other - Middle Name:AHUVA
Other - Last Name:HOLLANDER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:37 PONDEROSA DR
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-5156
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:400 MADISON AVE
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701-3225
Practice Address - Country:US
Practice Address - Phone:732-364-7770
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-15
Last Update Date:2019-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00994600363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics