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General NPI Number Information
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NPI Number | 1750243077
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Entity Type | Individual
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Provider Name | MARISA BURRELL LPN
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Gender | Female
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Dates
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Enumeration Date | 11/25/2025
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Last Update Date | 11/25/2025
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Provider Practice Location Address
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Address Line | 4215 ELY AVE
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City | BRONX
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State | NY
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Zip | 10466-2035
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Country | US
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Telephone | 646-886-1899
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Fax |
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Provider Business Mailing Address
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Address Line | 45 VALLEY AVE
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City | BRIDGEPORT
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State | CT
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Zip | 06606-3755
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Country | US
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Telephone |
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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 | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | 319395
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | 44316
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License Number State | CT
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