Provider Demographics
NPI:1336856467
Name:M AND M PSYCHIATRIC NURSE PRACTITIONER SERVICES PLLC
Entity Type:Organization
Organization Name:M AND M PSYCHIATRIC NURSE PRACTITIONER SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARINA
Authorized Official - Middle Name:
Authorized Official - Last Name:CECERE
Authorized Official - Suffix:
Authorized Official - Credentials:DNP
Authorized Official - Phone:516-581-1357
Mailing Address - Street 1:3280 OCEAN HARBOR DR
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11572-3546
Mailing Address - Country:US
Mailing Address - Phone:516-581-1357
Mailing Address - Fax:917-410-6866
Practice Address - Street 1:7 MARCUS GARVEY BLVD STE 427
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11206-5303
Practice Address - Country:US
Practice Address - Phone:516-581-1357
Practice Address - Fax:917-410-6866
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-28
Last Update Date:2022-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty