Individual
SUZETTE MARIANO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
20 HEWES ST, PORT JEFFERSON STATION, NY 11776-4004
(631) 897-3784
Mailing address
20 HEWES ST, PORT JEFFERSON STATION, NY 11776-4004
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
635696
NY
Other
Enumeration date
02/24/2012
Last updated
02/24/2012
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