1. Home
  2. Directory
  3. New York
  4. Melville
  5. Physician Assistant
  6. NPI Profile

MRS. MARISSA LYNN BLAU PA
NPI 1396100582
Physician Assistant in Melville, NY

Active since December 15, 2015
510 BROADHOLLOW RD., SUITE 100, MELVILLE, NY 11747(631) 424-3600(631) 424-2963 Get Directions Write a Review

NPPES record last updated: September 23, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Sep 23, 2022, Dec 15, 2015 (2 updates tracked since 2015).

About Mrs. Marissa Lynn Blau Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MRS. MARISSA LYNN BLAU PA (NPI 1396100582) is an individual physician assistant in Melville, New York, licensed in New York (019305) and active in the NPI registry since December 2015.

NPPES Registry Identity

NPI1396100582
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameMRS. MARISSA LYNN BLAUCredential: PA
Location Address510 BROADHOLLOW RD., SUITE 100Melville, NY 11747
Mailing Address510 Broadhollow Rd., Suite 100Melville, NY 11747 · (631) 424-3600 · Fax (631) 424-2963
Phone(631) 424-3600
Fax(631) 424-2963
Sole ProprietorNo
Enumeration DateDecember 15, 2015
Last NPPES UpdateSeptember 23, 20222 updates tracked since enumeration
NPPES CertifiedSeptember 23, 2022
✔ NPI 1396100582 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in NY · 019305
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
510 BROADHOLLOW RD., Melville, NY 11747
Open in Google Maps ↗

Other Names 1

Former Name (1)Mrs. Marissa Lynn Blau

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Marissa Blau's NPI number?

The NPI number for Marissa Blau is 1396100582. It was assigned to this individual provider in the NPPES registry on December 15, 2015. The provider is also known as Mrs. Marissa Lynn Blau.

Where is Marissa Blau located?

Marissa Blau practices at 510 Broadhollow Rd. Suite 100, Melville, NY 11747. The listed phone number is (631) 424-3600.

What is Marissa Blau's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

When was this NPI record last updated?

The NPPES record for Marissa Blau was last updated on September 23, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.