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NPI Code Detail

MEDICARE: MRS. ROSAFE AGBULOS VALENCIA RN

MEDICARE: MRS. ROSAFE AGBULOS VALENCIA RN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163WP2201XAmbulatory Care Registered NurseNO57298NJ

General Provider Information

NPI Number : 1336110733
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. ROSAFE AGBULOS VALENCIA RN
Provider Business Mailing Address
First Line : 1721 PHILADELPHIA AVE.
Second Line :
City : WHITING
State : NJ
Zip : 08759
Country : US
Telephone Number : 732-350-4056
Fax Number :
Provider Business Practice Location Address
First Line : 1721 PHILADELPHIA AVE
Second Line :
City : WHITING
State : NJ
Zip : 08759-2628
Country : US
Telephone Number : 732-350-4056
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/01/2006
Last Update Date : 07/08/2007

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