Individual
MR. DALE BASILLOTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
35 S HACKENSACK AVE, KEARNY, NJ 07032-4635
(201) 395-5600
Mailing address
260 W CLAY AVE, ROSELLE PARK, NJ 07204-1864
(908) 787-9966
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
Primary
26NR15446100
NJ
Other
Enumeration date
10/13/2019
Last updated
10/13/2019
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