Healthcare Provider Details

I. General information

NPI: 1023112463
Provider Name (Legal Business Name): MARIE BRANNIGAN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/07/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

755 PARK AVE 160C
HUNTINGTON NY
11743-3975
US

IV. Provider business mailing address

8 LEGHORN CT
HUNTINGTON STATION NY
11746-2857
US

V. Phone/Fax

Practice location:
  • Phone: 631-427-7553
  • Fax: 631-547-0464
Mailing address:
  • Phone: 631-549-8681
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number227651-1
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number26NR02608100
License Number StateNJ
# 3
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License NumberRN147743L
License Number StatePA
# 4
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberF301725-1
License Number StateNY
# 5
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberTP005903C
License Number StatePA
# 6
Primary TaxonomyN
Taxonomy Code364SP0808X
TaxonomyPsychiatric/Mental Health Clinical Nurse Specialist
License Number26NC02608100
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: