Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Maryanna Vrettos Domenic

Individual provider Registered Nurse · NPI 1689306433

Maryanna Vrettos Domenic is a Nurse Practitioner in Chester, New Jersey. Qualified in 2023, 3 years ago. Practices as a sole proprietor, works from 2 locations and accepts Medicare assignment. Licensed in New Jersey.

Years since qualifying
3
Licensed in
NJ
In the registry since
2022
Specialties on file
2

Practice location Address checks out

45 Perry St Unit 2
Chester, NJ 07930-3604
Phone: (908) 315-9913
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 475 Wall St, Princeton, NJ 08540-1509 — (908) 803-1779

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X · Licence 26NJ15070600 (NJ)
Registered Nurse Taxonomy 163W00000X · Licence 26NR16641700 (NJ)

Record details

NPI number1689306433
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedJune 29, 2022
Last updated in NPPESOctober 17, 2024
Certification dateOctober 17, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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