Individual
MARISA VANNESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3401 N BROAD ST # 411, PHILADELPHIA, PA 19140-5189
(267) 225-4156
Mailing address
1440 MOUNT VERNON ST APT 411, PHILADELPHIA, PA 19130-3474
(570) 933-5714
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
MT233562
PA
Other
Enumeration date
05/13/2025
Last updated
05/13/2025
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