Individual provider · Type 1 NPI
Vanessa Disla, PA
Surgical Physician Assistant · Hackensack, NJ
NPI number
1801090253
Active
Practice location
30 Prospect Ave
Hackensack, NJ 07601-1915
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Surgical Physician Assistant | 363AS0400X | PA9105002 (FL) |
| Surgical Physician Assistant Primary | 363AS0400X | 25MP00184500 (NJ) |
Surgical Physician Assistant: Definition to come...
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About NPI 1801090253
Vanessa Disla, PA's National Provider Identifier is 1801090253, issued on Jun 11, 2007. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Hackensack, NJ. The record was last updated on Mar 25, 2020.