Individual
MARY S KISSWANY
Active
Individual
MARY S KISSWANY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DO
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
2024-00315
NC
208M00000X
Hospitalist Physician
000246
LA
208M00000X
Hospitalist Physician
25MB08436700
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0172146
—
NJ
01
—
48090-NON PAR
UHP-PHYS ASSOC OF TEANECK
NJ
01
—
P00667653
RAILROAD MEDICARE
NJ
01
—
P00829442
RR MEDICARE-TEANECK
NJ
Enumeration date
07/21/2008
Last updated
06/25/2026
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