Provider Demographics
NPI:1780615443
Name:GALANO-ROGERS, SOCORRO I (APN-C)
Entity type:Individual
Prefix:
First Name:SOCORRO
Middle Name:I
Last Name:GALANO-ROGERS
Suffix:
Gender:F
Credentials:APN-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 WESTLEY RD
Mailing Address - Street 2:
Mailing Address - City:OLD BRIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:08857-3562
Mailing Address - Country:US
Mailing Address - Phone:732-591-0987
Mailing Address - Fax:732-591-0987
Practice Address - Street 1:90 BERGEN ST STE 400
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07103-2425
Practice Address - Country:US
Practice Address - Phone:973-972-2929
Practice Address - Fax:973-972-8620
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2007-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00052900363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner