Provider Demographics
NPI:1518467661
Name:CAPECE, MARYANNE BAKICH (RNC (PSYCHIATRY))
Entity Type:Individual
Prefix:MRS
First Name:MARYANNE
Middle Name:BAKICH
Last Name:CAPECE
Suffix:
Gender:F
Credentials:RNC (PSYCHIATRY)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 HEMPSTEAD AVE STE H9
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE CENTRE
Mailing Address - State:NY
Mailing Address - Zip Code:11570-4034
Mailing Address - Country:US
Mailing Address - Phone:516-764-5522
Mailing Address - Fax:516-764-0154
Practice Address - Street 1:30 HEMPSTEAD AVE STE H9
Practice Address - Street 2:
Practice Address - City:ROCKVILLE CENTRE
Practice Address - State:NY
Practice Address - Zip Code:11570-4034
Practice Address - Country:US
Practice Address - Phone:516-764-5522
Practice Address - Fax:516-764-0154
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-15
Last Update Date:2018-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY296007-1163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health