Healthcare Provider Details

I. General information

NPI: 1922499318
Provider Name (Legal Business Name): MS. MARY GRACE TRESCHITTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/07/2015
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 E 95TH ST
NEW YORK NY
10128-4000
US

IV. Provider business mailing address

225 E 95TH ST APT 20K
NEW YORK NY
10128-4606
US

V. Phone/Fax

Practice location:
  • Phone: 201-777-0482
  • Fax:
Mailing address:
  • Phone: 201-777-0482
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberF402304
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number739269
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: