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Individual

MARYANNA VRETTOS DOMENIC

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
45 PERRY ST UNIT 2, CHESTER, NJ 07930-3604
(908) 315-9913
Mailing address
45 PERRY ST UNIT 2, CHESTER, NJ 07930-3604
(908) 315-9913

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
26NR16641700
NJ
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
26NJ15070600
NJ

Other

Enumeration date
06/29/2022
Last updated
10/17/2024
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