Individual
MARIEL JENSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CPNP, DNP
Contact information
Practice address
390 MONTAUK HWY, WEST ISLIP, NY 11795-4403
(631) 422-0700
(631) 422-0703
Mailing address
390 MONTAUK HWY, WEST ISLIP, NY 11795-4403
(631) 422-0700
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
F382728-1
NY
Other
Enumeration date
06/13/2016
Last updated
05/08/2018
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