Provider Demographics
NPI:1497478853
Name:SOLIS SANCHEZ, CAROL ROXANA (APN)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:ROXANA
Last Name:SOLIS SANCHEZ
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:222 DRAKE AVE
Mailing Address - Street 2:
Mailing Address - City:ROSELLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07203-1412
Mailing Address - Country:US
Mailing Address - Phone:908-217-8005
Mailing Address - Fax:
Practice Address - Street 1:3196 JOHN F KENNEDY BLVD
Practice Address - Street 2:
Practice Address - City:UNION CITY
Practice Address - State:NJ
Practice Address - Zip Code:07087-0708
Practice Address - Country:US
Practice Address - Phone:833-617-0501
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-21
Last Update Date:2022-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ01367200363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care