Marissa Mae Vanboden

Primary specialty

Other Specialist/TechnologistTaxonomy code 246Z00000X

Practice address

218 Luddington St
Syracuse, NY 13206-3161

Phone

(315) 313-4326

NPI assigned

Apr 3, 2026

Last updated

Apr 3, 2026By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1775174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775174400000",
    "number": "1063353951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "218 LUDDINGTON ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132063161",
            "telephone_number": "315-313-4326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "218 LUDDINGTON ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132063161",
            "telephone_number": "315-313-4326"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "218 Luddington St",
            "address_purpose": "LOCATION",
            "city": "Syracuse",
            "state": "NY",
            "postal_code": "132063161",
            "country_code": "US",
            "telephone_number": "315-313-4326",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VANBODEN",
        "first_name": "MARISSA",
        "middle_name": "MAE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-04-03",
        "last_updated": "2026-04-03",
        "certification_date": "2026-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246Z00000X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sally Jo Van Ostrand
• Melanie Stephanie Van Schaick, OTL
• Thomas W Vanarnam Jr., PA
• Vanbeveren and Yankowitz Physical Therapists, PC
• Patrick J Vanbeveren, PT
• Michelle Lyla Vandee
• Ella Vanderbilt
• Holly Ann Vanderhoff, PH.D.
• Thomas Jefferson Vandermeer, MD
• Audrey Victoria Vandewall, DO

• Other Specialist/Technologist in Syracuse, NY
• Providers in Syracuse, NY by specialty
• Other Specialist/Technologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.