Miss Mia Deritis
Physician Assistant in Pennington, New Jersey
1073063012- Practice location
- 1 Capital Way, Pennington, NJ 08534-2520
- Phone
- 800-637-2374
- Fax
- —
- Last updated
- December 9, 2024
Mia Deritis is a Physician Assistant based in Pennington, NJ. Mia Deritis practices in Pennington, NJ. The NPI Number for Mia Deritis is 1073063012 and holds a License No. 25MP00518400 (NJ). The current practice location address for Mia Deritis is 1 Capital Way, Pennington, NJ 08534-2520 and can be reached out via phone at 800-637-2374.
Provider Profile Details
- NPI Number
- 1073063012
- Provider Name
- Mia Deritis
- Provider Entity Type
- Individual
- Gender
- Female
- Address
- 1 Capital Way, Pennington, NJ 08534-2520
- Phone Number
- 800-637-2374
- Primary Taxonomy
- Physician Assistant · 363A00000X
- Sole Proprietor
- No
- Provider Enumeration Date
- October 13, 2016
- Last Update Date
- December 9, 2024
- Certification Date
- December 9, 2024
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 1 Capital Way
Pennington, NJ 08534-2520 - City
- Pennington
- State
- New Jersey
- Zip
- 08534-2520
- Phone Number
- 800-637-2374
Provider Business Mailing Address Details
- Address
- 1 Capital Way
Pennington, NJ 08534-2520 - City
- Pennington
- State
- NJ
- Zip
- 08534-2520
- Phone Number
- 800-637-2374
License Information
- License Number (1)
- 25MP00518400
- License State (1)
- NJ
- Taxonomy (1)
- Physician Assistant, Medical · 363AM0700X
- License Number (2)
- 25MP00518400
- License State (2)
- NJ
- Taxonomy (2)
- Physician Assistant · 363A00000X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
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Frequently Asked Questions
What is the NPI number of Miss Mia Deritis?
The NPI number of Miss Mia Deritis is 1073063012. It was assigned on October 13, 2016 and is currently active in the NPPES registry.
What is the specialty of Miss Mia Deritis?
Miss Mia Deritis is registered under the primary taxonomy Physician Assistant (code 363A00000X), licensed in NJ under license number 25MP00518400.
Where does Miss Mia Deritis practice?
The practice location is 1 Capital Way, Pennington, NJ 08534-2520. The office can be reached at 800-637-2374 (phone).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1073063012 directly on the NPPES registry website.