Marissa Destefano, PA-C
Physician Assistant, Surgical in Wilmington, DE. Individual provider (NPI-1).
NPI number1750103479
StatusActive
Last updated in NPPESSep 10, 2025
Details
- NPI
- 1750103479
- Entity type
- Individual (NPI-1)
- Name
- Marissa Destefano
- Credential
- PA-C
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Oct 25, 2024
- Certification date
- Sep 10, 2025
- Last updated
- Sep 10, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363AS0400X | Physician Assistant, Surgical | 25MP00947700 | NJ | Yes |
| 363A00000X | Physician Assistant | C5-0012164 | DE |
Practice location
1941 Limestone Rd Ste 101Wilmington, DE 19808-5413
Phone 302-655-9494
Mailing address
100 Patura RdModena, NY 12548-5310
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All 16 Surgical Physician Assistant providers in Wilmington · All 8,243 providers in Wilmington
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