Healthcare Provider Details

I. General information

NPI: 1275267098
Provider Name (Legal Business Name): MARYANA SEKH NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MARYANA SEKH

II. Dates (important events)

Enumeration Date: 07/16/2022
Last Update Date: 07/16/2022
Certification Date: 07/16/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 UNION SQ E
NEW YORK NY
10003-3314
US

IV. Provider business mailing address

1511 BRIGHTWATER AVE APT 5H
BROOKLYN NY
11235-5821
US

V. Phone/Fax

Practice location:
  • Phone: 212-844-8409
  • Fax:
Mailing address:
  • Phone: 646-643-3238
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF347446-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: