Individual
MARISSA J FISTOLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1000 ASYLUM AVE, SUITE 3212, HARTFORD, CT 06105-1770
(860) 522-1171
(860) 493-6524
Mailing address
1000 ASYLUM AVE, SUITE 3212, HARTFORD, CT 06105-1770
(860) 522-1171
(860) 493-6524
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
001926
CT
363AM0700X
Medical Physician Assistant
0019267
CT
Other
Enumeration date
07/18/2007
Last updated
04/16/2012
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