Individual
MARISA RENEE ALTAMIRANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
113 W ESSEX ST, MAYWOOD, NJ 07607-1023
(201) 289-5551
Mailing address
113 W ESSEX ST, MAYWOOD, NJ 07607-1023
(201) 289-5551
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
25MP00637000
NJ
Other
Enumeration date
08/05/2021
Last updated
12/18/2024
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