# MARYANNA DOMENIC APN

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** Domenic Psychiatry
- **Organization subpart:** No

## Provider details

- **NPI number:** 1891524237
- **Authorized official:** MARYANNA VRETTOS DOMENIC MSN, APN, PMHNP-BC (PSYCHIATRIC NURSE PRACTITIONER)
- **Authorized official phone:** (908) 315-9913

## Contact information

- **Practice address:** 45 PERRY ST UNIT 2, CHESTER, NJ 07930-3604
- **Practice address phone:** (908) 315-9913
- **Practice address fax:** (973) 494-5213
- **Mailing address:** 45 PERRY ST UNIT 2, CHESTER, NJ 07930-3604
- **Mailing address phone:** (908) 315-9913
- **Mailing address fax:** (973) 494-5213

## Taxonomy

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

## Other

- **Enumeration date:** 08/01/2024
- **Last updated:** 09/02/2025