Individual
CHARLY ANNE BISSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
90 MILLBURN AVE STE 206, MILLBURN, NJ 07041-1933
(973) 763-7546
Mailing address
124 TABOR ST, BRENTWOOD, NY 11717-7912
(917) 572-0227
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
25MP00770400
NJ
Other
Enumeration date
03/06/2023
Last updated
12/26/2024
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