Healthcare Provider Details

I. General information

NPI: 1366760878
Provider Name (Legal Business Name): MARTINE MORPEAU NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/07/2010
Last Update Date: 05/07/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

229 W 36TH ST 10TH FLOOR
NEW YORK NY
10018-7529
US

IV. Provider business mailing address

61 MANORHAVEN BLVD
PORT WASHINGTON NY
11050-1627
US

V. Phone/Fax

Practice location:
  • Phone: 516-484-4400
  • Fax: 516-484-6084
Mailing address:
  • Phone: 516-883-7100
  • Fax: 516-883-7474

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF335660
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: