Provider Demographics
NPI:1619560380
Name:SCOLOVENO, ROBERT L (PHD, RN, CCRN)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:L
Last Name:SCOLOVENO
Suffix:
Gender:M
Credentials:PHD, RN, CCRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:207 GRANDVIEW DR
Mailing Address - Street 2:
Mailing Address - City:BRANCHBURG
Mailing Address - State:NJ
Mailing Address - Zip Code:08853-4150
Mailing Address - Country:US
Mailing Address - Phone:908-507-6788
Mailing Address - Fax:
Practice Address - Street 1:207 GRANDVIEW DR
Practice Address - Street 2:
Practice Address - City:BRANCHBURG
Practice Address - State:NJ
Practice Address - Zip Code:08853-4150
Practice Address - Country:US
Practice Address - Phone:908-507-6788
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-14
Last Update Date:2021-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NO12085900163WC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine