Individual
MARISSA TAYLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5550 MERRICK RD, MASSAPEQUA, NY 11758-6238
(631) 673-1314
Mailing address
5550 MERRICK RD, MASSAPEQUA, NY 11758-6238
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
404544
NY
Other
Enumeration date
01/31/2023
Last updated
01/31/2023
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