Provider Demographics
NPI:1821620535
Name:TOUZIN, MARIE SERGINE (NP, PMHNP)
Entity Type:Individual
Prefix:
First Name:MARIE
Middle Name:SERGINE
Last Name:TOUZIN
Suffix:
Gender:F
Credentials:NP, PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1967 WEHRLE DR STE 1086
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14221-8452
Mailing Address - Country:US
Mailing Address - Phone:845-467-3854
Mailing Address - Fax:
Practice Address - Street 1:15 FORTUNE ROAD
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:NY
Practice Address - Zip Code:10941-1258
Practice Address - Country:US
Practice Address - Phone:845-551-1427
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-11
Last Update Date:2021-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY659203163WC1500X
NYF403106363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WC1500XNursing Service ProvidersRegistered NurseCommunity Health