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Individual

MR. JIMMY MARSEILLE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
NP

Contact information

Practice address
21 12TH AVE, HUNTINGTON STATION, NY 11746-2104
(631) 988-0848
Mailing address
21 12TH AVE, HUNTINGTON STATION, NY 11746-2104

Taxonomy

Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
779861
NY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
2025067416
NY

Other

Enumeration date
09/29/2025
Last updated
10/06/2025
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