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Individual

EVANGELINA M. ROQUE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP-C

Contact information

Practice address
6-20 PLAZA RD, FAIR LAWN, NJ 07410-3113
(201) 797-2003
(201) 797-7003
Mailing address
6-20 PLAZA RD, FAIR LAWN, NJ 07410-3113
(201) 797-2003
(201) 797-7003

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
26NJ00788600
NJ
363LG0600X
Gerontology Nurse Practitioner
26NJ00788600
NJ

Other

Enumeration date
12/20/2017
Last updated
11/05/2025
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