Provider Demographics
NPI:1568940039
Name:MAREUS, STECY (REGISTER NURSE)
Entity Type:Individual
Prefix:
First Name:STECY
Middle Name:
Last Name:MAREUS
Suffix:
Gender:F
Credentials:REGISTER NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 SAXON AVE APT 15
Mailing Address - Street 2:
Mailing Address - City:BAY SHORE
Mailing Address - State:NY
Mailing Address - Zip Code:11706-7031
Mailing Address - Country:US
Mailing Address - Phone:631-520-3979
Mailing Address - Fax:
Practice Address - Street 1:18 SAXON AVE APT 15
Practice Address - Street 2:
Practice Address - City:BAY SHORE
Practice Address - State:NY
Practice Address - Zip Code:11706-7031
Practice Address - Country:US
Practice Address - Phone:631-520-3979
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-06
Last Update Date:2018-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY7265841163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty