Individual
BEATRICE CARRILLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
145 S DEAN ST, ENGLEWOOD, NJ 07631-3513
(201) 308-5591
Mailing address
145 S DEAN ST, ENGLEWOOD, NJ 07631-3513
(201) 308-5591
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
26NJ00655300
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1005116
—
NJ
Enumeration date
08/13/2016
Last updated
08/13/2016
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