Healthcare Provider Details

I. General information

NPI: 1891997862
Provider Name (Legal Business Name): ROXANN GARCIA SALGO APN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/01/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

36 MADISON AVE
MADISON NJ
07940-1434
US

IV. Provider business mailing address

53 TINTLE RD
KINNELON NJ
07405-1900
US

V. Phone/Fax

Practice location:
  • Phone: 973-408-3414
  • Fax:
Mailing address:
  • Phone: 973-838-8826
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC1400X
TaxonomyCollege Health Registered Nurse
License Number26NN03265400
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: