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General NPI Number Information
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NPI Number | 1427380799
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Entity Type | Individual
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Provider Name | MARISSA FLEURY ATC, PA
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Gender | Female
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Dates
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Enumeration Date | 02/11/2010
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 664 STONELEIGH AVE SUITE 300 SOMERS ORTHOPEDIC
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City | CARMEL
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State | NY
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Zip | 10512
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Country | US
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Telephone | 845-278-8400
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Fax |
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Provider Business Mailing Address
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Address Line | 664 STONELEIGH AVE STE 300
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City | CARMEL
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State | NY
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Zip | 10512-3990
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Country | US
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Telephone | 845-278-8400
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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 | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 67 001843
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 020986
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License Number State | NY
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