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Individual
MARISSA GENTILE
Active
Individual
MARISSA GENTILE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
092991
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
092991
LICENSE
NY
Enumeration date
01/30/2015
Last updated
01/30/2015
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