Healthcare Provider Details

I. General information

NPI: 1518881341
Provider Name (Legal Business Name): MARISSA HOBIKA NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/05/2026
Last Update Date: 08/08/2026
Certification Date: 08/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 INTREPID LN
SYRACUSE NY
13205-2546
US

IV. Provider business mailing address

100 INTREPID LN
SYRACUSE NY
13205-2546
US

V. Phone/Fax

Practice location:
  • Phone: 315-671-8796
  • Fax: 315-637-3694
Mailing address:
  • Phone: 315-671-8796
  • Fax: 315-637-3694

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF360037-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: