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Individual
MARISSA FLEURY
Active
Individual
MARISSA FLEURY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC, PA
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
67 001843
NY
363A00000X
Physician Assistant
Primary
020986
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A400175968
MEDICARE PTAN
NY
Enumeration date
02/11/2010
Last updated
07/21/2022
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