Provider Demographics
NPI:1780187096
Name:CARROLL, ROBERT PATRICK II (FNP-BC)
Entity type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:PATRICK
Last Name:CARROLL
Suffix:II
Gender:M
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:70 S ORANGE AVE STE 235
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07039-4915
Mailing Address - Country:US
Mailing Address - Phone:973-607-4911
Mailing Address - Fax:
Practice Address - Street 1:70 S ORANGE AVE STE 235
Practice Address - Street 2:
Practice Address - City:LIVINGSTON
Practice Address - State:NJ
Practice Address - Zip Code:07039-4915
Practice Address - Country:US
Practice Address - Phone:973-607-4911
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-13
Last Update Date:2025-05-26
Deactivation Date:2023-05-22
Deactivation Code:
Reactivation Date:2023-06-27
Provider Licenses
StateLicense IDTaxonomies
NJ261QU0200X
FLAPRN11026128363LF0000X
NY351807363LF0000X
NJ26NJ14999600363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care