Healthcare Provider Details

I. General information

NPI: 1194859041
Provider Name (Legal Business Name): MARLENE J PIKE RN, CNS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/15/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1561 LONG POND RD SUITE 414
ROCHESTER NY
14626-4117
US

IV. Provider business mailing address

1561 LONG POND RD SUITE 414
ROCHESTER NY
14626-4117
US

V. Phone/Fax

Practice location:
  • Phone: 585-723-7000
  • Fax:
Mailing address:
  • Phone: 585-723-7000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SP0809X
TaxonomyAdult Psychiatric/Mental Health Clinical Nurse Specialist
License Number205132
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: