Healthcare Provider Details

I. General information

NPI: 1265054530
Provider Name (Legal Business Name): DONNA MARCHISOTTO RN, MSN,PMHCNS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/10/2020
Last Update Date: 05/10/2020
Certification Date: 05/10/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2311 83RD ST
BROOKLYN NY
11214-2715
US

IV. Provider business mailing address

2311 83RD ST
BROOKLYN NY
11214-2715
US

V. Phone/Fax

Practice location:
  • Phone: 347-586-8183
  • Fax:
Mailing address:
  • Phone: 347-586-8183
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SP0809X
TaxonomyAdult Psychiatric/Mental Health Clinical Nurse Specialist
License Number325399
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: