Individual
MRS. TINA GRACE VACANTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, FNP-BC, RN-BC
Contact information
Practice address
20 PROSPECT AVE STE 201, HACKENSACK, NJ 07601-1999
(551) 996-4849
(551) 996-5703
Mailing address
20 PROSPECT AVE STE 201, HACKENSACK, NJ 07601-1999
(551) 996-4849
(551) 996-5703
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
26NJ00630000
NJ
Other
Enumeration date
06/28/2016
Last updated
08/23/2022
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