Organization · Type 2 NPI
Impact Health New Jersey PC
Nurse Practitioner · Roselle, NJ
Practice location
580 Raritan Rd
Roselle, NJ 07203-2446
Fax (718) 337-8658
Mailing address
20 E Sunrise Hwy
Valley Stream, NY 11581-1260
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Internal Medicine Physician | 207R00000X | None listed |
| Nurse Practitioner Primary | 363L00000X | None listed |
Nurse Practitioner: (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance wit…
About NPI 1487399689
Impact Health New Jersey PC's National Provider Identifier is 1487399689, issued on May 2, 2022. The primary taxonomy on file is Nurse Practitioner (363L00000X), and the practice location is in Roselle, NJ. The record was last updated on Mar 25, 2026.