Provider Demographics
NPI:1346651049
Name:MARCHESE, CARMELA MARIA (RN)
Entity Type:Individual
Prefix:
First Name:CARMELA
Middle Name:MARIA
Last Name:MARCHESE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 E 42ND ST FL 6
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10017-5831
Mailing Address - Country:US
Mailing Address - Phone:646-453-6900
Mailing Address - Fax:646-453-6900
Practice Address - Street 1:220 E 42ND ST FL 6
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10017-5831
Practice Address - Country:US
Practice Address - Phone:646-453-6900
Practice Address - Fax:646-453-6900
Is Sole Proprietor?:No
Enumeration Date:2014-05-15
Last Update Date:2023-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY682494-1163W00000X
NY308834-01363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY682494-1Medicaid