Provider Demographics
NPI:1265732218
Name:MISSERI, BRITTANY ANNE
Entity type:Individual
Prefix:
First Name:BRITTANY
Middle Name:ANNE
Last Name:MISSERI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38 HEMLOCK ST
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10309-4289
Mailing Address - Country:US
Mailing Address - Phone:646-372-3210
Mailing Address - Fax:
Practice Address - Street 1:943 RENSSELAER AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10309-2227
Practice Address - Country:US
Practice Address - Phone:646-372-3210
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-25
Last Update Date:2021-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program