Marissa Brennan, PA-C
Physician Assistant, Medical in New London, Connecticut
1902324205- Practice location
- 365 Montauk Ave, New London, CT 06320-4700
- Phone
- 860-271-4364
- Fax
- 860-444-5114
- Last updated
- September 4, 2025
Marissa Brennan is a Physician Assistant, Medical based in New London, CT. Marissa Brennan practices in New London, CT and has the professional credentials of PA-C. The NPI Number for Marissa Brennan is 1902324205 and holds a License No. 3987 (CT). The current practice location address for Marissa Brennan is 365 Montauk Ave, New London, CT 06320-4700 and can be reached out via phone at 860-271-4364 and via fax at 860-444-5114.
Provider Profile Details
- NPI Number
- 1902324205
- Provider Name
- Marissa Brennan
- Credential
- PA-C
- Provider Entity Type
- Individual
- Gender
- Female
- Address
- 365 Montauk Ave, New London, CT 06320-4700
- Phone Number
- 860-271-4364
- Fax Number
- 860-444-5114
- Primary Taxonomy
- Physician Assistant, Medical · 363AM0700X
- Sole Proprietor
- No
- Other Names
- -- Marissa Tennant (Former Name)
- Provider Enumeration Date
- September 7, 2017
- Last Update Date
- September 4, 2025
- Certification Date
- September 4, 2025
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 365 Montauk Ave
New London, CT 06320-4700 - City
- New London
- State
- Connecticut
- Zip
- 06320-4700
- Phone Number
- 860-271-4364
- Fax Number
- 860-444-5114
Provider Business Mailing Address Details
- Address
- 365 Montauk Ave
New London, CT 06320-4700 - City
- New London
- State
- CT
- Zip
- 06320-4700
- Phone Number
- 860-271-4364
- Fax Number
- 860-444-5114
License Information
- License Number (1)
- 3987
- License State (1)
- CT
- Taxonomy (1)
- Physician Assistant, Medical · 363AM0700X · Primary
- License Number (2)
- PA01528
- License State (2)
- RI
- Taxonomy (2)
- Physician Assistant, Medical · 363AM0700X
- Taxonomy (3)
- Physician Assistant · 363A00000X
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
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Frequently Asked Questions
What is the NPI number of Marissa Brennan, PA-C?
The NPI number of Marissa Brennan, PA-C is 1902324205. It was assigned on September 7, 2017 and is currently active in the NPPES registry.
What is the specialty of Marissa Brennan, PA-C?
Marissa Brennan, PA-C is registered under the primary taxonomy Physician Assistant, Medical (code 363AM0700X), licensed in CT under license number 3987.
Where does Marissa Brennan, PA-C practice?
The practice location is 365 Montauk Ave, New London, CT 06320-4700. The office can be reached at 860-271-4364 (phone) or 860-444-5114 (fax).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1902324205 directly on the NPPES registry website.