Provider Demographics
NPI:1629447628
Name:PARISI, MINDY (MSN, APN-C)
Entity Type:Individual
Prefix:
First Name:MINDY
Middle Name:
Last Name:PARISI
Suffix:
Gender:F
Credentials:MSN, APN-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 POMPTON AVE
Mailing Address - Street 2:
Mailing Address - City:VERONA
Mailing Address - State:NJ
Mailing Address - Zip Code:07044-2917
Mailing Address - Country:US
Mailing Address - Phone:973-857-3400
Mailing Address - Fax:
Practice Address - Street 1:50 POMPTON AVE
Practice Address - Street 2:
Practice Address - City:VERONA
Practice Address - State:NJ
Practice Address - Zip Code:07044-2917
Practice Address - Country:US
Practice Address - Phone:973-857-3400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-20
Last Update Date:2015-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00578200363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health