Individual
MARISSA VERRICO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
145 HOSPITAL AVE STE 204, DU BOIS, PA 15801-1464
(814) 371-4361
Mailing address
100 HOSPITAL AVE, DU BOIS, PA 15801-1440
(814) 375-4200
(814) 375-4232
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
MA059912
PA
363A00000X
Physician Assistant
Primary
OA004532
PA
363AM0700X
Medical Physician Assistant
Primary
—
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103553090
—
PA
01
—
716500
MC PTAN
PA
Enumeration date
06/08/2018
Last updated
05/29/2026
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