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General NPI Number Information
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NPI Number | 1376227330
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Entity Type | Organization
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Legal Business Name | MARILEE MEDICAL, LLC
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Dates
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Enumeration Date | 06/12/2023
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Last Update Date | 03/27/2025
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Provider Practice Location Address
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Address Line | 290 LAFAYETTE AVE STE 202
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City | HAWTHORNE
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State | NJ
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Zip | 07506-1928
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Country | US
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Telephone | 973-363-4850
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Fax | 973-363-4606
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Provider Business Mailing Address
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Address Line | 571 LAFAYETTE AVE
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City | HAWTHORNE
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State | NJ
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Zip | 07506-2424
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Country | US
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Telephone | 201-280-2007
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Fax |
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Authorized Official
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Title or Position | NURSE PRACTITIONER
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Name | KIMBERLY A MILETTI
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Credential | NP-C
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Telephone | 201-466-0938
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WG0000X
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Taxonomy Name | General Practice Registered Nurse
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License Number |
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License Number State |
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