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Individual

MARISSA L STANKUS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
171 GRANDVIEW AVE STE 201, WATERBURY, CT 06708-2520
(203) 578-4630
(203) 578-4629
Mailing address
171 GRANDVIEW AVE STE 201, WATERBURY, CT 06708-2520
(203) 578-4630
(203) 578-4629

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary

Other

Enumeration date
09/16/2008
Last updated
10/26/2017
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