National Provider Identifier
Marissa Jodi McClintock, PA-C
Marissa Jodi McClintock, PA-C is listed in the NPPES registry with a primary specialty of Physician Assistant in Ithaca, NY and a listed phone number of (617) 990-4085.
Profile Overview
- NPI
- 1861470338
- Provider Type
- Individual
- Primary Specialty
- Physician Assistant
- Enumeration Date
- January 05, 2006
- Last Updated
- October 10, 2007
Practice Location
- 107 Cayuga Heights RD
- Apt 11
- Ithaca, NY 14850-2152
Phone: (617) 990-4085
Specialties
- Physician Assistant (363A00000X)
- Surgical Physician Assistant (363AS0400X)
Full Record
- NPI
- 1861470338
- Entity Type
- Individual
- Last Name
- McClintock
- First Name
- Marissa
- Middle Name
- Jodi
- Credential
- PA-C
- Mailing Street Address
- 107 Cayuga Heights RD
- Mailing Address Line 2
- Apt 11
- Mailing City
- Ithaca
- Mailing State
- NY
- Mailing ZIP Code
- 14850-2152
- Mailing Country
- US
- Mailing Phone
- (617) 990-4085
- Practice Street Address
- 107 Cayuga Heights RD
- Practice Address Line 2
- Apt 11
- Practice City
- Ithaca
- Practice State
- NY
- Practice ZIP Code
- 14850-2152
- Practice Country
- US
- Practice Phone
- (617) 990-4085
- Enumeration Date
- January 05, 2006
- Last Updated
- October 10, 2007
- Sex
- Female
- Sole Proprietor
- No
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Physician Assistant (363A00000X), Surgical Physician Assistant (363AS0400X)