Healthcare Provider Details

I. General information

NPI: 1336856467
Provider Name (Legal Business Name): M AND M PSYCHIATRIC NURSE PRACTITIONER SERVICES PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/28/2022
Last Update Date: 10/28/2022
Certification Date: 10/28/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 MARCUS GARVEY BLVD STE 427
BROOKLYN NY
11206-5303
US

IV. Provider business mailing address

3280 OCEAN HARBOR DR
OCEANSIDE NY
11572-3546
US

V. Phone/Fax

Practice location:
  • Phone: 516-581-1357
  • Fax: 917-410-6866
Mailing address:
  • Phone: 516-581-1357
  • Fax: 917-410-6866

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: DR. MARINA CECERE
Title or Position: OWNER
Credential: DNP
Phone: 516-581-1357