Individual
MR. JOSE RRAFAEL MARIOTTI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
102 RIVERS EDGE RD, NEW YORK, NY 10035-1163
(646) 672-5800
Mailing address
102 RIVERS EDGE RD, NEW YORK, NY 10035-1163
(646) 672-5800
Taxonomy
Speciality
Code
Description
License number
State
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
Primary
575671
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
575671
LICENSE
NY
Enumeration date
09/02/2022
Last updated
09/02/2022
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