# MV NURSE PRACTITIONER IN ADULT HEALTH PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** MV MEDICAL
- **Organization subpart:** No

## Provider details

- **NPI number:** 1790510899
- **Authorized official:** MARIA VITSENTZOS NP (DIRECTOR)
- **Authorized official phone:** (516) 790-4227

## Contact information

- **Practice address:** 104-08 METROPOLITAN AVE, FOREST HILL, NY 11375
- **Practice address phone:** (516) 790-4227
- **Mailing address:** 14 RIVERDALE AVE, MASSAPEQUA, NY 11758-7729

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208VP0000X | Pain Medicine Physician | — | NULL | Yes |
| 208VP0000X | Pain Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 09/06/2024
- **Last updated:** 09/09/2024