Provider Demographics
NPI:1205537206
Name:RIFKIN, MARISSA BROOKE (DDS)
Entity type:Individual
Prefix:
First Name:MARISSA
Middle Name:BROOKE
Last Name:RIFKIN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 KITCHEL RD
Mailing Address - Street 2:
Mailing Address - City:MOUNT KISCO
Mailing Address - State:NY
Mailing Address - Zip Code:10549-4516
Mailing Address - Country:US
Mailing Address - Phone:914-960-6355
Mailing Address - Fax:
Practice Address - Street 1:722 W 168TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032-3727
Practice Address - Country:US
Practice Address - Phone:212-305-6754
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-15
Last Update Date:2023-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program