Individual
MARY T. MITSKAVICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3700 ROUTE 33, SUITE 101, NEPTUNE, NJ 07753
(732) 280-7855
(732) 280-7815
Mailing address
3700 ROUTE 33, SUITE 101, NEPTUNE, NJ 07753
(732) 280-7855
(732) 280-7815
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
MA63523
NJ
Other
Enumeration date
06/10/2005
Last updated
01/30/2012
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