Individual
MIA GENERA FORTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
4755 OGLETOWN STANTON RD, NEWARK, DE 19718-2200
(302) 733-6510
(302) 733-3340
Mailing address
8096 HERITAGE DR, ALBURTIS, PA 18011-2714
(610) 554-6013
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
C5-0012201
DE
363A00000X
Physician Assistant
Primary
MA066138
PA
Other
Enumeration date
10/30/2024
Last updated
12/20/2024
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