Individual
MARISA ANNE LETHEBY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSN, FNP-C, FNP-BC
Contact information
Practice address
1161 VICTORY BLVD, STATEN ISLAND, NY 10301-3621
(718) 818-1162
Mailing address
PO BOX 25213, BELFAST, ME 04915-2003
(718) 818-4531
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
346781
NY
Other
Enumeration date
11/17/2020
Last updated
10/16/2024
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