Individual
MRS. MAUREEN ANN TITA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
111 SEVENTH STREET, SUITE 111, GARDEN CITY, NY 11570
(516) 639-1787
(516) 594-5019
Mailing address
111 SEVENTH STREET, SUITE 111, GARDEN CITY, NY 11530
(516) 639-1787
(516) 594-5019
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
340084-1
NY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
401075
NY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
F401075
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01666971
—
NY
Enumeration date
08/24/2006
Last updated
10/25/2011
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