Provider Demographics
NPI:1790128908
Name:MARSELLA, JENNIFER LEIGH (MD)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:LEIGH
Last Name:MARSELLA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:135 CORPORATE WOODS
Mailing Address - Street 2:PO BOX 278984, 2ND FLOOR
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14623-1473
Mailing Address - Country:US
Mailing Address - Phone:585-242-9164
Mailing Address - Fax:
Practice Address - Street 1:2337 S CLINTON AVE
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14618-2645
Practice Address - Country:US
Practice Address - Phone:585-341-7575
Practice Address - Fax:585-341-7595
Is Sole Proprietor?:No
Enumeration Date:2013-04-08
Last Update Date:2023-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY286317363A00000X, 2084S0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084S0012XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologySleep Medicine
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant