Marie Ann Addesa, APN, D.C.
Individual provider Active NPI Independent Medical Examiner Chiropractor · Passaic, NJ
NPI 1013119973 · NPPES record last updated Sep 15, 2023
Key facts
- NPI
- 1013119973
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Independent Medical Examiner Chiropractor 111NI0013X
- License
- 38MC00467000 (NJ)
- Practice address
- 647 Main Ave Ste 202
Passaic, NJ 07055-4962 - Phone
- (973) 778-2300
- NPI assigned
- Jun 4, 2007
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| APRN11027588 | FL | MD | Family Nurse Practitioner |
| 26NJ14914900 | NJ | MD | Family Nurse Practitioner |
| 350691 | NY | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Passaic Family Chiropractic, PC | Family | Current | Accepting new patients |
| Advanced Therapeutic Modalities, LLC | Family | Current |
Accepting new patients |
Locations
647 Main Ave
Ste 202
Passaic, NJ 07055
Phone (973) 777-5400
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 350691 | NY | |
| Family Nurse Practitioner | 363LF0000X | APRN11027588 | FL | |
| Family Nurse Practitioner | 363LF0000X | 26NJ14914900 | NJ | |
| Independent Medical Examiner Chiropractor | 111NI0013X | 38MC00467000 | NJ | Yes |
Addresses
Primary practice location
647 Main Ave Ste 202
Passaic, NJ 07055-4962
Mailing address
647 Main Ave Ste 202
Passaic, NJ 07055-4962
Phone (973) 778-2300
Other providers in Passaic, NJ
- Absolute Chiropractic & Physical Therapy, LLC
- Ynes D Accilien
- Accredited Health Services
- Accredited Health Services
- Accredited Health Services, Inc.
- Olaniyi Samson Adedayo
- Alexander Adler
- Arvin Jay Adler
- Advanced Interventional Pain Management, LLC
- After Hours Physical Therapy LLC
All providers in Passaic, NJ · Independent Medical Examiner Chiropractor in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 15, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.