Healthcare Provider Details

I. General information

NPI: 1972256642
Provider Name (Legal Business Name): AMIROSE CARDINES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/01/2022
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

462 ELIZABETH AVE
SOMERSET NJ
08873-5107
US

IV. Provider business mailing address

462 ELIZABETH AVE
SOMERSET NJ
08873-5107
US

V. Phone/Fax

Practice location:
  • Phone: 866-389-2727
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF346856-01
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number26NJ01070300
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: