Healthcare Provider Details

I. General information

NPI: 1821291782
Provider Name (Legal Business Name): ROSELYN EFFAH RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/07/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

261 CONNECTICUT DR STE 5
BURLINGTON NJ
08016-4177
US

IV. Provider business mailing address

18 PARKWOOD DR APT H
SOUTH AMBOY NJ
08879-2372
US

V. Phone/Fax

Practice location:
  • Phone: 180-095-0606
  • Fax:
Mailing address:
  • Phone: 732-952-2637
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WM0705X
TaxonomyMedical-Surgical Registered Nurse
License Number26NO12432900
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: