Healthcare Provider Details

I. General information

NPI: 1609381300
Provider Name (Legal Business Name): MARISA LYNN RAGONESI AUD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/05/2017
Last Update Date: 02/26/2026
Certification Date: 02/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

U.S. ARMY HEALTH CLINIC GRAFENWOHR UNIT 28130
APO AE
09114
US

IV. Provider business mailing address

PSC 411 BOX 5182
APO AE
09112-0052
US

V. Phone/Fax

Practice location:
  • Phone: 314-590-2487
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number002776
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: