Individual
MARISSA MALIAKAL ANTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3401 CIVIC CENTER BLVD, DIVISION OF PEDIATRIC HEADACHE MEDICINE, PHILADELPHIA, PA 19104
(267) 825-3170
Mailing address
41 WINDSOR DR, JERICHO, NY 11753-1327
(516) 661-5143
Taxonomy
Speciality
Code
Description
License number
State
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
Primary
MD472478
PA
Other
Enumeration date
03/29/2016
Last updated
07/12/2021
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