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General NPI Number Information
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NPI Number | 1104622455
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Entity Type | Individual
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Provider Name | MARISSA GHIROLI APRN
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Gender | Female
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Dates
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Enumeration Date | 02/19/2025
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Last Update Date | 09/17/2025
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Provider Practice Location Address
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Address Line | 20 YORK ST
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City | NEW HAVEN
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State | CT
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Zip | 06510-3220
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Country | US
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Telephone | 208-688-4242
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Fax |
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Provider Business Mailing Address
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Address Line | 14 RICHILL RD
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City | BRANFORD
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State | CT
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Zip | 06405-2604
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 119834
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 14652
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License Number State | CT
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