Individual
MARISSA KRYSTAL SENISE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1 GUSTAVE L LEVY PL, NEW YORK, NY 10029-6504
(212) 241-9502
Mailing address
61 CLOSTER RD, PALISADES, NY 10964-1528
(201) 835-9632
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
308901
NY
Other
Enumeration date
08/21/2018
Last updated
08/21/2018
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