Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mrs. Marissa Lynn Blau, PA

Individual provider Physician Assistant · NPI 1396100582

Mrs. Marissa Lynn Blau, PA is a Physician Assistant in Melville, New York. Licensed in New York. Registered with an NPI since 2015.

Licensed in
NY
In the registry since
2015
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

510 Broadhollow Rd Ste 100
Melville, NY 11747
Phone: (631) 424-3600
Fax: (631) 424-2963
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 019305 (NY)

Record details

NPI number1396100582
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedDecember 15, 2015
Last updated in NPPESSeptember 23, 2022
Certification dateSeptember 23, 2022

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