Mckibban, Marisa H
Mckibban, Marisa H is an sole proprietor health care provider with primary practice located at 300 Central Ave , East Orange NJ 07018-2819. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Mckibban, Marisa H can be contacted via phone (973) 470-3000.Contact Information
Primary practice address
300 Central Ave
East Orange NJ 07018-2819
Phone: (973) 470-3000
Fax: (973) 470-3506
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | 25MP00167000 | New Jersey |
Profile Details
| NPI number | 1174607600 |
|---|---|
| LBN Legal business name | Mckibban, Marisa H |
| Credentials | Physician Assistant (PA) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Oct 24th, 2006 |
| Last updated | Nov 1st, 2011 - about 15 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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