Individual
MARISA CEVASCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D., M.P.H
Contact information
Practice address
3400 SPRUCE ST, PHILADELPHIA, PA 19104-4238
(215) 662-2050
(215) 615-0829
Mailing address
3400 SPRUCE ST, PHILADELPHIA, PA 19104-4238
(215) 662-2050
(215) 615-0829
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
288226
NY
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
MD467275
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
288226
NYS LICENSE
NY
Enumeration date
03/31/2008
Last updated
05/07/2019
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