Provider Demographics
NPI:1265145593
Name:GRASSIA, MIKAYLA (PA-C)
Entity type:Individual
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First Name:MIKAYLA
Middle Name:
Last Name:GRASSIA
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Gender:F
Credentials:PA-C
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Mailing Address - Street 1:360 US HIGHWAY 1 BYP UNIT 102
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:NH
Mailing Address - Zip Code:03801-7105
Mailing Address - Country:US
Mailing Address - Phone:603-410-6700
Mailing Address - Fax:603-319-8303
Practice Address - Street 1:738 HOOKSETT RD
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03104-2617
Practice Address - Country:US
Practice Address - Phone:603-384-3900
Practice Address - Fax:603-384-3912
Is Sole Proprietor?:No
Enumeration Date:2023-01-02
Last Update Date:2024-02-21
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant