Individual
MARIELLE DURYEA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1275 YORK AVE, NEW YORK, NY 10065-6007
(212) 639-3166
Mailing address
6353 77TH ST, MIDDLE VILLAGE, NY 11379-1303
(917) 880-1189
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
F310565-01
NY
Other
Enumeration date
03/07/2024
Last updated
11/18/2024
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