Marisa Rose Doll, PA-C
Physician Assistant in Yaphank, NY. Individual provider (NPI-1).
NPI number1831865534
StatusActive
Last updated in NPPESFeb 10, 2025
Details
- NPI
- 1831865534
- Entity type
- Individual (NPI-1)
- Name
- Marisa Rose Doll
- Credential
- PA-C
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Aug 22, 2021
- Certification date
- Feb 10, 2025
- Last updated
- Feb 10, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | 5585 | SC | Yes |
| 363A00000X | Physician Assistant | – | – | |
| 363A00000X | Physician Assistant | 027122 | NY |
Other names
- Marisa Balbo (Former Name)
Practice location
527 Boulevard EYaphank, NY 11980-7512
Phone 631-504-0427
Mailing address
101 Hospital RdPatchogue, NY 11772-4870
Phone 631-745-2857
Other practice locations
905 Verdae Blvd Ste 101
Greenville, SC 29607-4098
Greenville, SC 29607-4098
Phone 864-990-1910 · Fax 864-990-1911
101 Hospital Rd
Patchogue, NY 11772-4870
Patchogue, NY 11772-4870
Phone 631-654-7100
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