Individual
MARISSA JEAN BRUSSTAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
51 N 39TH ST, SUITE W130, PHILADELPHIA, PA 19104-2640
(215) 662-9436
Mailing address
51 N 39TH ST, SUITE W130, PHILADELPHIA, PA 19104-2640
(215) 662-9436
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
MA052755
PA
Other
Enumeration date
07/23/2008
Last updated
11/18/2016
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