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
Fax: (973) 470-3506
Website:

Health care specialties

SpecialtyCodeLicense #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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