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Individual
MARISSA DAWN YASGUR
Active
Individual
MARISSA DAWN YASGUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
26NJ00949100
NJ
363LF0000X
Family Nurse Practitioner
345230
NY
363LP2300X
Primary Care Nurse Practitioner
Primary
345230
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
26NJ00949100
MEDICAL LICENSE
NJ
Enumeration date
05/12/2020
Last updated
06/30/2025
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