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Marissa Jean Brusstar

Physician Assistant

Physician Assistants & Advanced Practice Nursing Providers

51 N 39th St, Suite W130, Philadelphia, PA 19104-2640

PECOS Enrollment

This provider is enrolled in PECOS as MARISSA BRUSSTAR.

Based on the most recent information from CMS, provider Marissa Jean Brusstar is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 5 days ago.

Profile Details

Provider ID
1750546396
Provider Type
Individual
Full Name
Brusstar, Marissa Jean
Credential
PA-C

Gender
Female
Sole Proprietor
No
Enumeration Date
7/23/2008
Last Updated
11/18/2016

Contact Information

Practice Location

51 N 39th St, Suite W130, Philadelphia, PA 19104-2640

(215) 662-9436

Unlisted Fax

Mailing Location

51 N 39th St, Suite W130, Philadelphia, PA 19104-2640

(215) 662-9436

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 363AM0700X Primary	Description Physician Assistant Physician Assistants & Advanced Practice Nursing Providers	License MA052755 Pennsylvania

Marissa Jean Brusstar

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

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