Individual
MARC VANILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
110 REHILL AVE, SOMERVILLE, NJ 08876-2519
(908) 685-2200
Mailing address
6400 SW 20TH AVE APT 108, GAINESVILLE, FL 32607-3525
(917) 544-4844
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
11024787
FL
363LG0600X
Gerontology Nurse Practitioner
Primary
26NJ01461700
NJ
Other
Enumeration date
03/22/2023
Last updated
06/24/2024
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