Healthcare Provider Details

I. General information

NPI: 1376477547
Provider Name (Legal Business Name): CHRISTNA PIERRE MARSEILLE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/11/2026
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4418 RIDGE RD SUITE #1
WILLIAMSON NY
14589-9306
US

IV. Provider business mailing address

4418 RIDGE RD SUITE #1
WILLIAMSON NY
14589-9306
US

V. Phone/Fax

Practice location:
  • Phone: 315-589-4641
  • Fax:
Mailing address:
  • Phone: 315-589-4641
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number360058
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: