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General NPI Number Information
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NPI Number | 1477215853
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Entity Type | Individual
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Provider Name | DIANE MARISCA
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Gender | Female
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Dates
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Enumeration Date | 10/12/2021
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Last Update Date | 10/12/2021
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Provider Practice Location Address
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Address Line | 24 DORSET CIR
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City | CALDWELL
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State | NJ
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Zip | 07006-6123
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Country | US
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Telephone | 973-287-6336
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Fax |
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Provider Business Mailing Address
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Address Line | 24 DORSET CIR
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City | CALDWELL
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State | NJ
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Zip | 07006-6123
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Country | US
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Telephone | 845-893-0102
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Fax |
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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 | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number |
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License Number State |
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