Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Bryan Bolanosgonzalez

Individual provider Registered Nurse · NPI 1689409054

Bryan Bolanosgonzalez is a Nurse Practitioner in Paramus, New Jersey. Qualified in 2023, 3 years ago. Licensed in New Jersey.

Years since qualifying
3
Licensed in
NJ
In the registry since
2024
Specialties on file
2
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Practice location Address checks out

16 Arcadian Way Ste C2
Paramus, NJ 07652-1291
Phone: (908) 271-8368
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X · Licence 26NJ15345000 (NJ)
Registered Nurse Taxonomy 163W00000X · Licence 26NR19503300 (NJ)

Record details

NPI number1689409054
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedSeptember 5, 2024
Last updated in NPPESJune 29, 2026
Certification dateJune 29, 2026
Mailing address429-4 State Route 31 S, Washington, NJ 07882-4182

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Accepts Medicare assignment Not indicated

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