Individual
MARISSA JACKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MPAS, PA-C
Contact information
Practice address
20 YORK ST, NEW HAVEN, CT 06510-3220
(203) 688-3335
(203) 688-3336
Mailing address
20 YORK ST, SICU 7 SOUTH PAVILION, ROOM 7-109, NEW HAVEN, CT 06510-3220
(203) 688-3335
(203) 688-3336
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
—
—
363AS0400X
Surgical Physician Assistant
Primary
002773
CT
Other
Enumeration date
06/25/2012
Last updated
08/30/2021
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