Provider Demographics
NPI:1467560870
Name:MAURINO, MARISSA M (PA-C)
Entity Type:Individual
Prefix:
First Name:MARISSA
Middle Name:M
Last Name:MAURINO
Suffix:
Gender:F
Credentials:PA-C
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Mailing Address - Street 1:2535 ARTHUR KILL RD
Mailing Address - Street 2:HEALTHCARE ASSOCIATES IN MEDICINE PC
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10309-1207
Mailing Address - Country:US
Mailing Address - Phone:718-448-3210
Mailing Address - Fax:718-442-9085
Practice Address - Street 1:1099 TARGEE STREET
Practice Address - Street 2:HEALTHCARE ASSOCIATES IN MEDICINE PC
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10304-4310
Practice Address - Country:US
Practice Address - Phone:718-448-3210
Practice Address - Fax:718-442-9085
Is Sole Proprietor?:No
Enumeration Date:2006-08-26
Last Update Date:2019-09-24
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Provider Licenses
StateLicense IDTaxonomies
NY010075-1363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYMM0706133OtherDEA
NY010075-1OtherSTATE EDUC DEPT