Individual
MARTHA GEORGE MARCELLUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
134 NEW YORK AVE, FREEPORT, NY 11520-1538
(646) 416-3820
Mailing address
134 NEW YORK AVE, FREEPORT, NY 11520-1538
(646) 416-3820
Taxonomy
Speciality
Code
Description
License number
State
163WL0100X
Lactation Consultant (Registered Nurse)
Primary
623837-1
NY
163WM0705X
Medical-Surgical Registered Nurse
623837-1
NY
163WN0002X
Neonatal Intensive Care Registered Nurse
623837-1
NY
Other
Enumeration date
10/20/2016
Last updated
03/12/2025
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