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General NPI Number Information
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NPI Number | 1467724948
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Entity Type | Individual
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Provider Name | JOSEPH A MARSEILLE FPMHNP
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Gender | Male
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Dates
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Enumeration Date | 01/31/2012
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Last Update Date | 08/05/2024
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Provider Practice Location Address
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Address Line | 355 W 15TH ST
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City | DEER PARK
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State | NY
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Zip | 11729-6305
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Country | US
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Telephone | 631-988-2983
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Fax | 631-761-3129
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Provider Business Mailing Address
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Address Line | 21 12TH AVE
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City | HUNTINGTN STA
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State | NY
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Zip | 11746-2104
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Country | US
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Telephone | 631-547-1830
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Fax | 631-547-1830
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 634215
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | F405958-01
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License Number State | NY
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