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Individual

ROSELORE REGILUS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1143 PASSAIC AVE, LINDEN, NJ 07036-2058
(908) 659-8745
Mailing address
1143 PASSAIC AVE, LINDEN, NJ 07036-2058
(908) 659-8745

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
296886
NY

Other

Enumeration date
11/23/2010
Last updated
11/23/2010
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