Carrillo, Nicole

Carrillo, Nicole is an individual health care provider with primary practice located at 377 Jersey Ave Ste 450 , Jersey City NJ 07302-4397. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as her primary health care specialty. Carrillo, Nicole can be contacted via phone (201) 915-2525.

Contact Information

Primary practice address
377 Jersey Ave Ste 450 Jersey City NJ 07302-4397
Phone: (201) 915-2525
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 25MP00203400 New Jersey

Profile Details

NPI number 1063660983
LBN Legal business name Carrillo, Nicole
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 4th, 2008
Last updated Jan 25th, 2023 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1063660983 NPPES
New Jersey Other 25MP00203400 LICENSE

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