IndividualActive
Marissa Anto, M.D.
NPI 1114380128 · Neurology with Special Qualifications in Child Neurology Physician · Philadelphia, PA
Provider details
- NPI number
- 1114380128
- Entity type
- Individual
- Primary specialty
- Neurology with Special Qualifications in Child Neurology PhysicianAllopathic & Osteopathic Physicians
- Credential
- M.D.
- Sex
- Female
- Sole proprietor
- No
- License
- MD472478 (PA)
Specialties & taxonomies
- Neurology with Special Qualifications in Child Neurology PhysicianPrimary2084N0402XLicense MD472478 (PA)
Allopathic & Osteopathic Physicians
Practice location
3401 Civic Center Blvd
Division of Pediatric Headache Medicine
Philadelphia, PA 19104
Phone: (267) 825-3170
Approximate (ZIP-level) locationGet directions
Mailing address
41 Windsor Dr
Jericho, NY 11753-1327
Registry dates
- Enumerated
- 2016-03-29
- Last updated
- 2021-07-12
- Certified
- 2021-07-12
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.