Individual
MICHELE MARIE MAYER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P., C.N.M.
Contact information
Practice address
5225 NESCONSET HWY STE 70, PORT JEFFERSON STATION, NY 11776-2061
(631) 331-8777
(631) 474-9169
Mailing address
5225 NESCONSET HWY STE 70, PORT JEFFERSON STATION, NY 11776-2061
(631) 331-8777
(631) 474-9169
Taxonomy
Speciality
Code
Description
License number
State
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
Primary
001110
NY
367A00000X
Advanced Practice Midwife
001110
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001110
LICENSE
NY
Enumeration date
11/16/2006
Last updated
09/11/2025
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