Individual
MARISA HALSTEAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
30 N UNION ST STE 105, ROCHESTER, NY 14607-1345
(585) 232-8940
(585) 232-8687
Mailing address
30 N UNION ST STE 10, ROCHESTER, NY 14607-1345
(585) 232-8940
(585) 232-8687
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
022886
NY
Other
Enumeration date
11/20/2018
Last updated
12/18/2023
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