Provider Demographics
NPI:1750902268
Name:DIRIGE, MARY ANNE (AGPCNP-BC)
Entity type:Individual
Prefix:
First Name:MARY ANNE
Middle Name:
Last Name:DIRIGE
Suffix:
Gender:F
Credentials:AGPCNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 19TH ST
Mailing Address - Street 2:
Mailing Address - City:UNION CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07087-5406
Mailing Address - Country:US
Mailing Address - Phone:347-272-8498
Mailing Address - Fax:
Practice Address - Street 1:150 19TH ST
Practice Address - Street 2:
Practice Address - City:UNION CITY
Practice Address - State:NJ
Practice Address - Zip Code:07087-5406
Practice Address - Country:US
Practice Address - Phone:347-272-8498
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-06
Last Update Date:2020-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program