Individual
MARISSA FELASCO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
144 STANDART AVE, AUBURN, NY 13021-1508
(315) 255-1100
(315) 255-1322
Mailing address
1419 SALT SPRINGS RD, SYRACUSE, NY 13214-1302
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
029481
NY
Other
Enumeration date
02/03/2022
Last updated
01/20/2023
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