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General NPI Number Information
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NPI Number | 1295872976
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Entity Type | Individual
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Provider Name | MARIA COSTEA MISTHOS MD
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Gender | Female
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Dates
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Enumeration Date | 01/31/2007
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Last Update Date | 07/09/2019
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Provider Practice Location Address
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Address Line | 1 ANDERSON HILL RD
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City | BERNARDSVILLE
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State | NJ
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Zip | 07924-2350
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Country | US
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Telephone | 908-696-0808
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Fax | 908-696-9943
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Provider Business Mailing Address
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Address Line | 150 N FINLEY AVE
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City | BASKING RIDGE
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State | NJ
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Zip | 07920
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Country | US
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Telephone | 908-696-1400
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Fax | 908-696-9900
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | MA53009
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License Number State | NJ
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