Individual provider · Type 1 NPI

Marissa Amber Van Hennik, PA

Medical Physician Assistant · Waterbury, CT

NPI number 1740213727 Active

Practice location

56 Franklin St
Waterbury, CT 06706-1221

Call (203) 709-6004 Map

Fax (203) 709-3700

Specialties and licenses

TaxonomyCodeLicense
Medical Physician Assistant Primary 363AM0700X001324 (CT)

Medical Physician Assistant: Definition to come...

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About NPI 1740213727

Marissa Amber Van Hennik, PA's National Provider Identifier is 1740213727, issued on Jul 10, 2006. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Waterbury, CT. The record was last updated on Sep 12, 2007.