Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | 26NJ00667000 | NJ |
N | 363LG0600X | Nurse Practitioner - Gerontology | 26NJ00667000 | NJ |
NPI | 1043769003 |
---|---|
Provider Name | Ms. Sandra Vargas |
First Address | East Brunswick, NJ 08816-4045 |
Second Address | New Brunswick, NJ 08901-1928 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/09/2016 |
Last Update Date | 30/09/2016 |