Individual
MRS. RYANN LEIGH MATTESSICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ACNP
Contact information
Practice address
185 S ORANGE AVE, MSB I593, NEWARK, NJ 07103-2757
(973) 972-4708
(973) 972-9760
Mailing address
185 S ORANGE AVE, MSB I593, NEWARK, NJ 07103-2757
(973) 972-4708
(973) 972-9760
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
26NJ00205200
NJ
Other
Enumeration date
06/03/2009
Last updated
06/03/2009
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