Individual
MS. MARYELLEN CUCUZZO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
600 SUFFOLK AVE STE C, BRENTWOOD, NY 11717-4311
(631) 273-3712
(631) 273-3745
Mailing address
123 SINGINGWOOD DR, HOLBROOK, NY 11741-3024
(631) 472-4435
(631) 472-4435
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
F421100-1
NY
Other
Enumeration date
07/15/2013
Last updated
07/15/2013
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