Marissa Leigh Kistner, MS ED.

Primary specialty

Respiratory/Developmental/Rehabilitative Specialist/TechnologistTaxonomy code 225500000X

Practice address

4 Meadowood LN
Fort Salonga, NY 11768-2702

Phone

(631) 813-0940

NPI assigned

Dec 15, 2020

Last updated

Dec 15, 2020By 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

Credentials

Master of Science

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

{
    "created_epoch": "1607990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607990400000",
    "number": "1861088676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 MEADOWOOD LN",
            "city": "FORT SALONGA",
            "state": "NY",
            "postal_code": "117682702",
            "telephone_number": "631-813-0940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 MEADOWOOD LN",
            "city": "FORT SALONGA",
            "state": "NY",
            "postal_code": "117682702",
            "telephone_number": "631-813-0940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KISTNER",
        "first_name": "MARISSA",
        "middle_name": "LEIGH",
        "name_prefix": "Mrs.",
        "credential": "MS ED.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-12-15",
        "last_updated": "2020-12-15",
        "certification_date": "2020-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225500000X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ronita Adora Humphrey
• Laura Imbrosciano, OTR/L
• Catherine Jannuzzi, MA, ATR-BC, LCAT
• Patricia Johnson
• Jeannine Kennedy
• Giovanni Luca Kubanick
• Laura Marr LCSW Services, P.C.
• Jaime A Lelle, RN
• Laura L Marr, LCSW
• Teresa Anne Merlucci, LCSW

• Respiratory/Developmental/Rehabilitative Specialist/Technologist in Fort Salonga, NY
• Providers in Fort Salonga, NY by specialty
• Respiratory/Developmental/Rehabilitative Specialist/Technologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2020; 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.