Individual
MARISSA GIROLAMO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.P.M.
Contact information
Practice address
1234 SUMMER ST STE 202, STAMFORD, CT 06905-5510
(203) 323-1711
(203) 323-4649
Mailing address
1234 SUMMER ST STE 202, STAMFORD, CT 06905-5510
(203) 323-1171
(203) 323-4649
Taxonomy
Speciality
Code
Description
License number
State
213ES0131X
Foot Surgery Podiatrist
Primary
000558
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
022112
HEALTHNET
CT
01
—
030000558CT01
BLUE CROSS
CT
01
—
0328216002
CIGNA
CT
01
—
480000468
MEDICARE ID#
CT
01
—
95809
AETNA HEALTH PLAN
CT
Enumeration date
10/05/2005
Last updated
12/07/2020
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