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Organization
MARAVILLA, N.P. IN ADULT HEALTH P.C.
Active
Organization
MARAVILLA, N.P. IN ADULT HEALTH P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KATHLEEN MICHELLE LEMARIE NURSE PRACTITIONER (OWNER)
(914) 448-3680
Entity
Organization
Contact information
Practice address
409 NORTH BROADWAY, APT#39, YONKERS, NY 10701
(914) 448-3680
Mailing address
7 ODELL PLZ, YONKERS, NY 10701-1407
(914) 448-3680
(914) 222-8866
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
—
NULL
363LA2200X
Adult Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
10/17/2024
Last updated
10/17/2024
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