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General NPI Number Information
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NPI Number | 1568657328
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Entity Type | Individual
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Provider Name | MARISA FRISCIA MD
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Gender | Female
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Dates
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Enumeration Date | 09/13/2007
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Last Update Date | 12/31/2018
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Provider Practice Location Address
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Address Line | 200 RICHMOND AVE E STE 1
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City | MATTOON
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State | IL
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Zip | 61938-4652
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Country | US
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Telephone | 217-234-7000
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Fax | 217-234-7011
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Provider Business Mailing Address
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Address Line | PO BOX 61
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City | ARLINGTON
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State | VT
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Zip | 05250-0061
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Country | US
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Telephone | 802-375-6566
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Fax | 802-375-6828
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 042.0010507
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License Number State | VT
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 042-0010507
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License Number State | VT
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 036147975
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License Number State | IL
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