Provider Demographics
NPI:1548875875
Name:SAVIC, MARISA
Entity type:Individual
Prefix:
First Name:MARISA
Middle Name:
Last Name:SAVIC
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:221 CRESCENT ST STE 202
Mailing Address - Street 2:
Mailing Address - City:WALTHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02453-3425
Mailing Address - Country:US
Mailing Address - Phone:781-487-1107
Mailing Address - Fax:888-344-2016
Practice Address - Street 1:690 KINGERKAMACK RD
Practice Address - Street 2:STE. 204
Practice Address - City:ORADEL
Practice Address - State:NJ
Practice Address - Zip Code:07646
Practice Address - Country:US
Practice Address - Phone:551-278-9240
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-14
Last Update Date:2023-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11019148363LP0808X
PASP022469363LP0808X
NJ26NJ01406700363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health