Doctor Name: | BARBARA VASSALLO |
NPI Number: | 1437224888 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | APN |
License Number: | 26NN02442600 |
Business Practice Address: | 16 Roosevelt Drive Laurel Springs, NJ - 08021 |
Business Phone Number: | 8562326058 |
Business Fax Number: | 8562328260 |
Mailing Address: | 50 Turn Hill Drive, WILLINGBORO |
State: | NJ |
Postal Code: | 080463724 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 11/21/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LA2200X |
License Number: | 26NN02442600 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NJ |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Adult Health |
Taxonomy Definition: |