MEDICARE: MR. JOHN F MESSINA PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	006685	NY
2	363AS0400X	Surgical Physician Assistant	MP00179200	NJ

General Provider Information

NPI Number	:	1568575819
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JOHN F MESSINA PA

Provider Business Mailing Address
First Line	:	22 MARTINGALE DR
Second Line	:
City	:	SUSSEX
State	:	NJ
Zip	:	07461-2859
Country	:	US
Telephone Number	:	718-490-0037
Fax Number	:

Provider Business Practice Location Address
First Line	:	540 LAFAYETTE RD
Second Line	:
City	:	SPARTA
State	:	NJ
Zip	:	07871-3497
Country	:	US
Telephone Number	:	973-300-1553
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/17/2006
Last Update Date	:	07/22/2008

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Directions to “ MR. JOHN F MESSINA PA” Practice Location

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