Individual
SALVATORE JOSEPH DEGENNARO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
APRN
Contact information
Practice address
612 RUTHERFORD AVE # A, LYNDHURST, NJ 07071-1217
(201) 682-0515
Mailing address
126 LANCASTER RD, FREEHOLD, NJ 07728-3111
(201) 682-0515
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
26NJ15205800
NJ
363LG0600X
Gerontology Nurse Practitioner
Primary
26NJ15205800
NJ
Other
Enumeration date
09/21/2024
Last updated
12/17/2024
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