Provider Demographics
NPI:1295424570
Name:MARCHESE, NICOLE MICHELLE (RN)
Entity type:Individual
Prefix:MRS
First Name:NICOLE
Middle Name:MICHELLE
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 1:38 BERKLEY LN
Mailing Address - Street 2:
Mailing Address - City:SYOSSET
Mailing Address - State:NY
Mailing Address - Zip Code:11791-6108
Mailing Address - Country:US
Mailing Address - Phone:516-768-9994
Mailing Address - Fax:
Practice Address - Street 1:38 BERKLEY LN
Practice Address - Street 2:
Practice Address - City:SYOSSET
Practice Address - State:NY
Practice Address - Zip Code:11791-6108
Practice Address - Country:US
Practice Address - Phone:516-768-9994
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-03
Last Update Date:2023-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY693145367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered