Individual
MARYROSE WATERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
300 COMMUNITY DR, MANHASSET, NY 11030-3876
(516) 562-0100
Mailing address
87 TARDY LN N, WANTAGH, NY 11793-1930
(516) 473-3714
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
F431881-01
NY
Other
Enumeration date
11/24/2020
Last updated
11/24/2020
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