# MARCELLUS REGISITERED PROF NURSE AND NURSE PRACTITIONER IN ADULT HEALT

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Marcellus Wellness and Addiction Services
- **Organization subpart:** No

## Provider details

- **NPI number:** 1891488094
- **Authorized official:** MS. ERICA MACKENZIE LPN (OFFICE MANAGER)
- **Authorized official phone:** (917) 916-7871

## Contact information

- **Practice address:** 22 MITCHELL DR, MONROE TOWNSHIP, NJ 08831-7902
- **Practice address phone:** (516) 728-0672
- **Mailing address:** 265 SUNRISE HWY STE 1-726, ROCKVILLE CENTRE, NY 11570-4912
- **Mailing address phone:** (516) 728-0672
- **Mailing address fax:** (929) 810-3323

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LA2200X | Adult Health Nurse Practitioner | — | NULL | — |
| 363LA2200X | Adult Health Nurse Practitioner | — | — | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 06/01/2023
- **Last updated:** 06/01/2023