Individual
MIA LEIGH CARLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MMSPA
Contact information
Practice address
300 GRAND AVE STE 201, ENGLEWOOD, NJ 07631-6300
(201) 608-5656
(201) 608-5650
Mailing address
300 GRAND AVE STE 201, ENGLEWOOD, NJ 07631-6300
(201) 608-5656
(201) 608-5650
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
NJ
Other
Enumeration date
03/21/2025
Last updated
06/06/2025
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