Marissa Paige Macdonald, PA-C
Physician Assistant, Medical in Lake View, NY. Individual provider (NPI-1).
NPI number1962397331
StatusActive
Last updated in NPPESJun 9, 2025
Details
- NPI
- 1962397331
- Entity type
- Individual (NPI-1)
- Name
- Marissa Paige Macdonald
- Credential
- PA-C
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Jun 9, 2025
- Certification date
- Jun 9, 2025
- Last updated
- Jun 9, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363AM0700X | Physician Assistant, Medical | – | NY | Yes |
Practice location
6496 Hackberry DrLake View, NY 14085-9578
Phone 716-912-3514
Mailing address
6496 Hackberry DrLake View, NY 14085-9578
Phone 716-912-3514
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