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NPI Code Detail

MEDICARE: REEMA MISTRY PA-C

MEDICARE: REEMA MISTRY PA-C
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
1363A00000XPhysician Assistant

General Provider Information

NPI Number : 1295622447
Entity Type Code : Individual
Provider Name (Legal Business Name) : REEMA MISTRY PA-C
Provider Business Mailing Address
First Line : 200 HIGHLAND AVE STE 100B
Second Line :
City : GLEN RIDGE
State : NJ
Zip : 07028-1521
Country : US
Telephone Number : 973-969-3800
Fax Number :
Provider Business Practice Location Address
First Line : 200 HIGHLAND AVE STE 100B
Second Line :
City : GLEN RIDGE
State : NJ
Zip : 07028-1521
Country : US
Telephone Number : 973-969-3800
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/20/2025
Last Update Date : 08/28/2025

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Directions to “ REEMA MISTRY PA-C” Practice Location

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