Individual
SAMANTHA BORELLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
1 BAY AVE, MONTCLAIR, NJ 07042-4837
(973) 429-6000
Mailing address
1 TULIP CRES APT 1A, LITTLE FALLS, NJ 07424-1660
(718) 594-5959
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
26NR20484100
NJ
363L00000X
Nurse Practitioner
Primary
P01587000
NJ
Other
Enumeration date
11/04/2024
Last updated
12/19/2024
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