Individual
MARISSA BRENNAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
365 MONTAUK AVE, NEW LONDON, CT 06320-4700
(860) 271-4364
(860) 444-5114
Mailing address
365 MONTAUK AVE, NEW LONDON, CT 06320-4700
(860) 271-4364
(860) 444-5114
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
—
—
363AM0700X
Medical Physician Assistant
Primary
3987
CT
363AM0700X
Medical Physician Assistant
PA01528
RI
Other
Enumeration date
09/07/2017
Last updated
09/04/2025
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