Provider Demographics
NPI:1942736806
Name:GERONNURSING REGISTRY NORTHWEST INC.
Entity Type:Organization
Organization Name:GERONNURSING REGISTRY NORTHWEST INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CORPORATE SECRETARY
Authorized Official - Prefix:MR
Authorized Official - First Name:ROGER
Authorized Official - Middle Name:VICTOR
Authorized Official - Last Name:ARGUELLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-354-7698
Mailing Address - Street 1:PO BOX 552
Mailing Address - Street 2:
Mailing Address - City:NEW MILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06776-0552
Mailing Address - Country:US
Mailing Address - Phone:860-354-7698
Mailing Address - Fax:860-355-9703
Practice Address - Street 1:42 MAIN ST
Practice Address - Street 2:
Practice Address - City:NEW MILFORD
Practice Address - State:CT
Practice Address - Zip Code:06776-2830
Practice Address - Country:US
Practice Address - Phone:860-354-7698
Practice Address - Fax:860-355-9703
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-11
Last Update Date:2017-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care