MEDICARE: MARISSA TORRES LANGSETH NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LA2200X	Adult Health Nurse Practitioner	302535	NY

General Provider Information

NPI Number	:	1548237092
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARISSA TORRES LANGSETH NP

Provider Business Mailing Address
First Line	:	1 PENN PLZ
Second Line	:	SUITE 725
City	:	NEW YORK
State	:	NY
Zip	:	10119-0002
Country	:	US
Telephone Number	:	917-570-9144
Fax Number	:	212-216-6407

Provider Business Practice Location Address
First Line	:	1 PENN PLZ
Second Line	:	SUITE 725
City	:	NEW YORK
State	:	NY
Zip	:	10119-0002
Country	:	US
Telephone Number	:	917-570-9144
Fax Number	:	212-216-6407

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/03/2006
Last Update Date	:	01/29/2015

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