Individual
MS. MACKAYLA RENEE PROBASCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
911 SUNSET RD, BURLINGTON, NJ 08016-2250
(609) 387-8787
Mailing address
53 IVINS DR, NEW EGYPT, NJ 08533-2810
(732) 644-4029
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
25MP00550100
NJ
Other
Enumeration date
10/24/2019
Last updated
10/24/2019
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