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General NPI Number Information
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NPI Number | 1710586987
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Entity Type | Individual
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Provider Name | ROSEMARIE B LONDONO NP
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Gender | Female
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Dates
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Enumeration Date | 10/20/2020
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Last Update Date | 10/20/2020
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Provider Practice Location Address
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Address Line | 20 PROSPECT AVE STE 600
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City | HACKENSACK
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State | NJ
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Zip | 07601-1962
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Country | US
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Telephone | 201-597-4334
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Fax |
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Provider Business Mailing Address
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Address Line | 5701 BOULEVARD E APT 3E
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City | WEST NEW YORK
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State | NJ
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Zip | 07093-3604
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Country | US
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Telephone | 201-937-2234
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | 26NJ01067500
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License Number State | NJ
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