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

MS. Marissa Rose Bacon

Individual provider Specialist · NPI 1740788306

MS. Marissa Rose Bacon is a Specialist in Oswego, New York. Practices as a sole proprietor. Licensed in New York.

Licensed in
NY
In the registry since
2018
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Practice location Address checks out

159 W 1st St
Oswego, NY 13126-2045
Phone: (315) 342-9575
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Specialist (primary) Taxonomy 174400000X · Licence 2535489 (NY)

Record details

NPI number1740788306
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedJanuary 30, 2018
Last updated in NPPESJanuary 30, 2018

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