Provider Demographics
NPI:1861106510
Name:MARCHESSAULT, KATHRYN IRIS (PA-C)
Entity type:Individual
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First Name:KATHRYN
Middle Name:IRIS
Last Name:MARCHESSAULT
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Gender:F
Credentials:PA-C
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Mailing Address - Street 1:115 E ROGUES PATH
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON STATION
Mailing Address - State:NY
Mailing Address - Zip Code:11746-2741
Mailing Address - Country:US
Mailing Address - Phone:631-885-0227
Mailing Address - Fax:
Practice Address - Street 1:308 WILLOW AVE
Practice Address - Street 2:
Practice Address - City:HOBOKEN
Practice Address - State:NJ
Practice Address - Zip Code:07030-3808
Practice Address - Country:US
Practice Address - Phone:201-418-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-09
Last Update Date:2023-01-09
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant