Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | 26NJ00804900 | NJ |
NPI | 1023510245 |
---|---|
Provider Name | Marissa Rago |
First Address | Hillsborough, NJ 08844-1528 |
Second Address | Hillsborough, NJ 08844 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/03/2018 |
Last Update Date | 05/06/2018 |