Individual
MARISSA FAITH MADDALENA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1 DIAMOND HILL RD, BERKELEY HEIGHTS, NJ 07922-2104
(908) 273-4300
Mailing address
18 MIDWAY DR, LIVINGSTON, NJ 07039-4338
(908) 358-8753
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
25MP00398400
NJ
363AM0700X
Medical Physician Assistant
Primary
25MP00398400
NJ
Other
Enumeration date
06/13/2016
Last updated
04/08/2024
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