Individual
MARISSA HAKES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, CNM
Contact information
Practice address
4900 BROAD RD, SYRACUSE, NY 13215-2265
(315) 492-5011
Mailing address
4900 BROAD RD, SYRACUSE, NY 13215-2265
(315) 492-5875
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
750088
NY
367A00000X
Advanced Practice Midwife
Primary
—
NY
Other
Enumeration date
06/20/2023
Last updated
03/13/2026
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