Individual
MARY MORAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
108 BILBY ROAD, SUITE 201, HACKETTSTOWN, NJ 07840
(908) 684-3005
(908) 684-3301
Mailing address
108 BILBY ROAD, SUITE 201, HACKETTSTOWN, NJ 07840
(908) 684-3005
(908) 684-3301
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
25MP00384000
NJ
363AS0400X
Surgical Physician Assistant
25MP00384000
NJ
Other
Enumeration date
12/03/2015
Last updated
12/03/2015
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