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Individual

MARY CARRILLO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
140 PARK AVE, FLORHAM PARK, NJ 07932-1049
(973) 404-9700
(973) 377-4709
Mailing address
100 ROUTE 59, SUITE 105, SUFFERN, NY 10901-4927
(845) 357-5775
(845) 357-5777

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
26NR12741800
NJ
367500000X
Certified Registered Nurse Anesthetist
Primary
26NJ00602400
NJ

Other

Enumeration date
06/16/2015
Last updated
01/11/2018
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