Individual
GINA P DERITO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1 CLARA MAASS DR, BELLEVILLE, NJ 07109-3550
(973) 251-1095
Mailing address
3 CENTURY DR, PARSIPPANY, NJ 07054-4610
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
25MP00538900
NJ
Other
Enumeration date
07/17/2019
Last updated
11/07/2019
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