Individual
MARISSA DELACRUZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
181 LAFAYETTE RD, WEST BABYLON, NY 11704-4903
(718) 812-4740
Mailing address
181 LAFAYETTE RD, WEST BABYLON, NY 11704-4903
(718) 812-4740
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
554228
NY
Other
Enumeration date
09/16/2010
Last updated
09/16/2010
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