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NPI Code Detail

MEDICARE: MARIA VISCONI

MEDICARE: MARIA VISCONI
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
1363AM0700XMedical Physician Assistant017933NY

General Provider Information

NPI Number : 1710381207
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARIA VISCONI
Provider Business Mailing Address
First Line : 40 WASHINGTON AVE
Second Line :
City : DUMONT
State : NJ
Zip : 07628-3697
Country : US
Telephone Number : 201-600-7372
Fax Number :
Provider Business Practice Location Address
First Line : 40 WASHINGTON AVE
Second Line :
City : DUMONT
State : NJ
Zip : 07628-3697
Country : US
Telephone Number : 201-387-7055
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/13/2014
Last Update Date : 01/16/2020

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Directions to “ MARIA VISCONI ” Practice Location

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