Provider Demographics
NPI:1295622447
Name:MISTRY, REEMA (PA-C)
Entity type:Individual
Prefix:
First Name:REEMA
Middle Name:
Last Name:MISTRY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 PAULISON AVE APT 33
Mailing Address - Street 2:
Mailing Address - City:PASSAIC
Mailing Address - State:NJ
Mailing Address - Zip Code:07055-4878
Mailing Address - Country:US
Mailing Address - Phone:973-510-4105
Mailing Address - Fax:
Practice Address - Street 1:100 PAULISON AVE APT 33
Practice Address - Street 2:
Practice Address - City:PASSAIC
Practice Address - State:NJ
Practice Address - Zip Code:07055-4878
Practice Address - Country:US
Practice Address - Phone:973-510-4105
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-20
Last Update Date:2025-06-20
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant