Ms. Marisa H Mckibban, PA
Physician Assistant in East Orange, New Jersey
1174607600- Practice location
- 300 Central Ave, East Orange, NJ 07018-2819
- Phone
- 973-470-3000
- Fax
- 973-470-3506
- Last updated
- November 1, 2011
Marisa H Mckibban is a Physician Assistant based in East Orange, NJ. Marisa H Mckibban practices in East Orange, NJ and has the professional credentials of PA. The NPI Number for Marisa H Mckibban is 1174607600 and holds a License No. 25MP00167000 (NJ). The current practice location address for Marisa H Mckibban is 300 Central Ave, East Orange, NJ 07018-2819 and can be reached out via phone at 973-470-3000 and via fax at 973-470-3506.
Provider Profile Details
- NPI Number
- 1174607600
- Provider Name
- Marisa H Mckibban
- Credential
- PA
- Provider Entity Type
- Individual
- Gender
- Female
- Address
- 300 Central Ave, East Orange, NJ 07018-2819
- Phone Number
- 973-470-3000
- Fax Number
- 973-470-3506
- Primary Taxonomy
- Physician Assistant · 363A00000X
- Sole Proprietor
- Yes
- Other Names
- -- Marisa Gatta, PA (Former Name)
- Provider Enumeration Date
- October 24, 2006
- Last Update Date
- November 1, 2011
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 300 Central Ave
East Orange, NJ 07018-2819 - City
- East Orange
- State
- New Jersey
- Zip
- 07018-2819
- Phone Number
- 973-470-3000
- Fax Number
- 973-470-3506
Provider Business Mailing Address Details
- Address
- 104 South Ave W
Cranford, NJ 07016-2652 - City
- Cranford
- State
- NJ
- Zip
- 07016-2652
- Phone Number
- 609-320-1302
- Fax Number
- 973-470-3506
License Information
- License Number
- 25MP00167000
- License State
- NJ
- Taxonomy
- 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 Ms. Marisa H Mckibban, PA?
The NPI number of Ms. Marisa H Mckibban, PA is 1174607600. It was assigned on October 24, 2006 and is currently active in the NPPES registry.
What is the specialty of Ms. Marisa H Mckibban, PA?
Ms. Marisa H Mckibban, PA is registered under the primary taxonomy Physician Assistant (code 363A00000X), licensed in NJ under license number 25MP00167000.
Where does Ms. Marisa H Mckibban, PA practice?
The practice location is 300 Central Ave, East Orange, NJ 07018-2819. The office can be reached at 973-470-3000 (phone) or 973-470-3506 (fax).
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 1174607600 directly on the NPPES registry website.