Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Marc Vanillo

Individual provider Gerontology Nurse Practitioner · NPI 1770286668

Marc Vanillo is a Nurse Practitioner in Somerville, New Jersey. Qualified in 2022, 4 years ago. Practices with Rwjbh Observation Associates LLC, a 971-clinician group and accepts Medicare assignment. Licensed in Florida and New Jersey.

Years since qualifying
4
Licensed in
FL, NJ
In the registry since
2023
Specialties on file
2

Practice location Address checks out

110 Rehill Ave
Somerville, NJ 08876-2519
Phone: (908) 685-2200
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Gerontology Nurse Practitioner (primary) Taxonomy 363LG0600X · Licence 26NJ01461700 (NJ)
Gerontology Nurse Practitioner Taxonomy 363LG0600X · Licence 11024787 (FL)

Record details

NPI number1770286668
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedMarch 22, 2023
Last updated in NPPESJune 24, 2024
Certification dateJune 24, 2024
Mailing address6400 Sw 20th Ave Apt 108, Gainesville, FL 32607-3525

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Rwjbh Observation Associates Llc — 971 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount