Healthcare Provider Details

I. General information

NPI: 1245395227
Provider Name (Legal Business Name): MARISA JEANNE OXIOS RD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/27/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

185 MERRITTS RD
FARMINGDALE NY
11735-3254
US

IV. Provider business mailing address

4 BALSAM LN
LEVITTOWN NY
11756-4802
US

V. Phone/Fax

Practice location:
  • Phone: 516-860-7040
  • Fax:
Mailing address:
  • Phone: 516-860-7040
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: