Individual
MARYANNE MINISCHETTI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN APNC PHD
Contact information
Practice address
270 DAVIDSON AVE, SOMERSET, NJ 08873-4140
(732) 328-2639
Mailing address
135 W END AVE, SOMERVILLE, NJ 08876-1809
(908) 333-4008
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
26NC07289800
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0023701
—
NJ
01
—
527486
AGENCY PTAN #
NJ
Enumeration date
11/02/2006
Last updated
04/17/2018
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