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Individual

MARISSA F DWARICA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
REGISTERED NURSE

Contact information

Practice address
42-09 28TH ST, 25N 11TH FL, LONG ISLAND CITY, NY 11101
(347) 396-4794
Mailing address
2152 RALPH AVE, 346, BROOKLYN, NY 11234-5406
(718) 781-7654

Taxonomy

Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
528714
NY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
402580
NY

Other

Enumeration date
06/05/2012
Last updated
07/02/2019
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