Individual
VANESSA NICOLE CANOSA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
171 LAKE ST, RAMSEY, NJ 07446-2089
(201) 785-0011
Mailing address
171 LAKE ST, RAMSEY, NJ 07446-2089
(201) 785-0011
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
019770-1
NY
363A00000X
Physician Assistant
Primary
25MP00400700
NJ
Other
Enumeration date
08/22/2016
Last updated
01/19/2025
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