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General NPI Number Information
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NPI Number | 1346681640
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Entity Type | Individual
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Provider Name | MARYELLEN HORAN FNP
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Gender | Female
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Dates
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Enumeration Date | 07/15/2013
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Last Update Date | 05/20/2025
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Provider Practice Location Address
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Address Line | 34 MAPLE ST
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City | NORWALK
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State | CT
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Zip | 06850-3815
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Country | US
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Telephone | 203-852-2000
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Fax |
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Provider Business Mailing Address
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Address Line | 154 LAKE DR
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City | MAHOPAC
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State | NY
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Zip | 10541-3627
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Country | US
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Telephone | 845-729-3792
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 14803
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 338127
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License Number State | NY
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