Provider Demographics
NPI:1972795300
Name:SMARGIASSI, MARISSA L (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:MARISSA
Middle Name:L
Last Name:SMARGIASSI
Suffix:
Gender:F
Credentials:PA-C
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:199 NEW RD
Mailing Address - Street 2:CENTRAL SQUARE SUITE 62-63
Mailing Address - City:LINWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08221-1325
Mailing Address - Country:US
Mailing Address - Phone:609-926-3331
Mailing Address - Fax:609-926-3350
Practice Address - Street 1:199 NEW RD
Practice Address - Street 2:CENTRAL SQUARE SUITE 62-63
Practice Address - City:LINWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08221-1325
Practice Address - Country:US
Practice Address - Phone:609-926-3331
Practice Address - Fax:609-926-3350
Is Sole Proprietor?:No
Enumeration Date:2007-08-09
Last Update Date:2007-08-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MP00129800363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical