Healthcare Provider Details

I. General information

NPI: 1275465916
Provider Name (Legal Business Name): MARKISIC HEALTH AND WELLNESS NP IN ACUTE CARE PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/29/2026
Last Update Date: 05/29/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6817 MYRTLE AVE
GLENDALE NY
11385-7267
US

IV. Provider business mailing address

6 CONISTON CT
WAYNE NJ
07470-2482
US

V. Phone/Fax

Practice location:
  • Phone: 718-873-1444
  • Fax: 718-689-7365
Mailing address:
  • Phone: 917-815-4275
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: SAMRA MARKISIC
Title or Position: NP/PRESIDENT
Credential:
Phone: 718-873-1444