# MARISSA ELIZABETH DALE

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1972130789
- **Gender:** F

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2080P0216X | Pediatric Rheumatology Physician | 25MA13139900 | NJ | Yes |
| 2080P0216X | Pediatric Rheumatology Physician | 321044 | NY | — |
| 390200000X | Student in an Organized Health Care Education/Training Program | — | — | Yes |

## Other

- **Enumeration date:** 03/24/2020
- **Last updated:** 06/15/2026