Individual
MARISSA DESTEFANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1941 LIMESTONE RD STE 101, WILMINGTON, DE 19808-5413
(302) 655-9494
Mailing address
100 PATURA RD, MODENA, NY 12548-5310
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
C5-0012164
DE
363AS0400X
Surgical Physician Assistant
Primary
25MP00947700
NJ
Other
Enumeration date
10/25/2024
Last updated
09/10/2025
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