Individual
REBECCA A HERITAGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MMSC, PA-C
Contact information
Practice address
17 W RED BANK AVE, SUITE 207, WOODBURY, NJ 08096-1630
(856) 845-0664
(856) 845-7602
Mailing address
17 W RED BANK AVE, SUITE 207, WOODBURY, NJ 08096-1630
(856) 845-0664
(856) 845-7602
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
0010-03424
NC
363AM0700X
Medical Physician Assistant
Primary
25MP00318300
NJ
363AS0400X
Surgical Physician Assistant
0010-03424
NC
Other
Enumeration date
03/01/2012
Last updated
06/18/2015
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