Individual
MARISSA ANNE JENNINGS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
111 E 210TH ST, BRONX, NY 10467-2401
(718) 920-4321
Mailing address
111 E 210TH ST, BRONX, NY 10467-2401
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
033743
NY
Other
Enumeration date
04/22/2025
Last updated
04/22/2025
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