Individual
MISS MARISA KAE HANLON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1555 LONG POND RD, ROCHESTER, NY 14626-4122
(585) 723-7000
(585) 723-7280
Mailing address
100 KINGS HWY S, ROCHESTER, NY 14617-5504
(585) 723-7000
(585) 723-7280
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
025677
NY
Other
Enumeration date
10/25/2018
Last updated
10/20/2022
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