Sudomoin, Marissa Marie
Sudomoin, Marissa Marie is an individual health care provider with primary practice located at 255 W Lancaster Ave , Paoli PA 19301-1763. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Primary Care, which is considered as her primary health care specialty. Sudomoin, Marissa Marie can be contacted via phone (484) 565-1601.Contact Information
Primary practice address
255 W Lancaster Ave
Paoli PA 19301-1763
Phone: (484) 565-1601
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Primary Care | 363LP2300X | SP023134 | Pennsylvania |
Profile Details
| NPI number | 1518624360 |
|---|---|
| LBN Legal business name | Sudomoin, Marissa Marie |
| Credentials | Nurse Practitioner (NP) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 29th, 2021 |
| Last updated | Nov 29th, 2021 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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