Healthcare Provider Details

I. General information

NPI: 1255255253
Provider Name (Legal Business Name): CAROL J VARGO RN583619
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/05/2026
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1296 WARREN ST
ALPHA NJ
08865-4759
US

IV. Provider business mailing address

1296 WARREN ST
ALPHA NJ
08865-4759
US

V. Phone/Fax

Practice location:
  • Phone: 610-258-2985
  • Fax: 610-923-3573
Mailing address:
  • Phone: 610-258-2985
  • Fax: 610-923-3573

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN583619
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: