Healthcare Provider Details

I. General information

NPI: 1568393684
Provider Name (Legal Business Name): ANGELICA SALINA ROSARIO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/27/2026
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1015 N MAIN ST # A
PITMAN NJ
08071-2445
US

IV. Provider business mailing address

1015 N MAIN ST
PITMAN NJ
08071-2445
US

V. Phone/Fax

Practice location:
  • Phone: 856-896-4710
  • Fax:
Mailing address:
  • Phone: 856-896-4710
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number44SL07286300
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: