Provider Demographics
NPI:1023272739
Name:CREASAP, MARION CLAIRE (NP)
Entity type:Individual
Prefix:MRS
First Name:MARION
Middle Name:CLAIRE
Last Name:CREASAP
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5775 MOSHOLU AVE
Mailing Address - Street 2:APT 7B
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10471-2217
Mailing Address - Country:US
Mailing Address - Phone:718-601-2240
Mailing Address - Fax:
Practice Address - Street 1:423 E 23RD ST
Practice Address - Street 2:MENTAL HEALTH CLINIC ROOM 2649
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010-5011
Practice Address - Country:US
Practice Address - Phone:212-686-7500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-11
Last Update Date:2008-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF401050363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health