Individual
DYLAN JOHN WALIGROSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSN, RN, APN, FNP-C
Contact information
Practice address
30 PROSPECT AVE, HACKENSACK, NJ 07601-1915
(551) 996-2000
Mailing address
12I BROOKSIDE HTS, WANAQUE, NJ 07465-1630
(973) 897-2720
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
26NR18929100
NJ
163W00000X
Registered Nurse
832643
NY
363L00000X
Nurse Practitioner
Primary
26NJ01342100
NJ
363L00000X
Nurse Practitioner
350777
NY
Other
Enumeration date
07/20/2022
Last updated
05/25/2023
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