Individual
DR. MARISSA LYNNE MINCOLLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
750 E ADAMS ST, SYRACUSE, NY 13210-2342
(315) 464-7434
Mailing address
7510 MEADOW WOOD DR, NORTH SYRACUSE, NY 13212-1042
(315) 559-7137
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
270174
NY
Other
Enumeration date
04/27/2009
Last updated
05/20/2013
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