MARISSA AMBER VAN HENNIK

WATERBURY, CT
NPI1740213727
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363AM0700X Physician Assistant, Medical
(Licence: CT  001324)
Enumeration Date2006-07-10
Last Update Date2007-09-12
Business Address
-- MARISSA AMBER VAN HENNIK PA
56 FRANKLIN ST
WATERBURY, CT 06706-1221
Phone number: 203-709-6004
Mailing Address
-- MARISSA AMBER VAN HENNIK PA
56 FRANKLIN ST 3RD FLOOR
WATERBURY, CT 06706-1221
Phone number: 203-709-8873
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