Healthcare Provider Details

I. General information

NPI: 1215858972
Provider Name (Legal Business Name): MARISSA ROWLEY
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/21/2026
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 E 23RD ST STE 300
NEW YORK NY
10010-4588
US

IV. Provider business mailing address

326 PROSPECT AVE APT 7C
HACKENSACK NJ
07601-2612
US

V. Phone/Fax

Practice location:
  • Phone: 917-810-0620
  • Fax:
Mailing address:
  • Phone: 201-803-5062
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number408960
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: