Individual
DR. MARISSA FAMULARO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
1259 S CEDAR CREST BLVD STE 301, ALLENTOWN, PA 18103-6206
(610) 402-9400
Mailing address
1 ATWELL RD, COOPERSTOWN, NY 13326-1301
(607) 547-3480
(607) 547-5196
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
OT014239
PA
2086S0129X
Vascular Surgery Physician
297979
NY
2086S0129X
Vascular Surgery Physician
Primary
OS016404
PA
Other
Enumeration date
06/03/2011
Last updated
01/09/2024
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