Individual
MR. MARISSA M MUCCIO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
309 BLACK OAK RIDGE RD, WAYNE, NJ 07470-6504
(973) 692-9072
(973) 692-9071
Mailing address
309 BLACK OAK RIDGE RD, WAYNE, NJ 07470-6504
(973) 692-9072
(973) 692-9071
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
PT40QA00794200
NJ
Other
Enumeration date
02/27/2007
Last updated
07/08/2007
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