Individual
DR. MARISSA A BRUNETTI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
500 UNIVERSITY DR, HERSHEY, PA 17033-2360
(800) 243-1455
Mailing address
100 E PENN SQ, THE WANAMAKER BUILDING, 9TH FLOOR, NORTH, PHILADELPHIA, PA 19107-3323
(267) 425-9300
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
D63275
MD
2080P0203X
Pediatric Critical Care Medicine Physician
Primary
MD439981
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1026270630001
—
PA
01
—
226140EMD
MEDICARE PTAN
PA
05
—
409240600
—
MD
01
—
KJ50GB/64687801
CAREFIRST MARYLAND GBMC
MD
01
—
S1390049
CAREFIRST REGIONAL GBMC
MD
Enumeration date
07/18/2006
Last updated
09/25/2023
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