MARISSA LEANNE WALLACE (NPI# 1689932360) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1689932360 |
Entity Type | Individual |
Full Name | MARISSA LEANNE WALLACE |
Credential | NP |
Practice Address |
3078 Route 9w Ste 100 New Windsor NY 12553-6751 |
Mailing Address |
3078 Route 9w Suite 100 New Windsor NY 12553 |
Practice Telephone | (845) 561-3310 |
Practice Fax Number | 8455618728 |
Mailing Telephone | (845) 561-3310 |
Mailing Fax Number | 8455618728 |
Enumeration Date | 2012-05-01 |
Last Update Date | 2017-07-19 |
Gender Code | F |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 163W00000X | Registered Nurse | 653689-1 | NY | Nursing Service Providers |
Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
F308236 | NY | Physician Assistants & Advanced Practice Nursing Providers |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1043857527 | Marissa Steen Wallace | Social Worker | 4251 Kipling St Unit 560, Wheat Ridge, CO 80033-6800 | 2019-12-04 |
Street Address |
3078 ROUTE 9W STE 100 |
City | NEW WINDSOR |
State | NY |
Zip Code | 12553-6751 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1578080891 | Trevon Solivan | Licensed Practical Nurse | 40 Cedar Lane Apt 2, New Windsor, NY 12553 | 2017-08-28 |
1336695097 | Toni Casiano | Licensed Practical Nurse | 1204 Corporal Tremblay Way, New Windsor, NY 12553 | 2016-08-31 |
1952765729 | Chelsea Burawa | Speech-Language Pathologist | Hudson Valley Speech and Swallowing Therapy, 815 Blooming Grove Turnpike, New Windsor, NY 12553 | 2016-04-07 |
1740656586 | Juliana F Fiore | Physical Therapist | 219 Blooming Grove Turnpike, New Windsor, NY 12553 | 2015-08-17 |
1629472857 | Maryellen Banker | Social Worker | 10 Kayleen Dr., Windsor Counseling Group, New Windsor, NY 12553 | 2014-10-17 |
1720488398 | Stacey Browne | Speech-Language Pathologist | 119 Winding Brook Ct, New Windsor, NY 12553 | 2014-09-02 |
1154731404 | Greenburgh - North Castle Ufsd/kaplan Career Academy | Local Education Agency (LEA) | 623 Blooming Grove Turnpike, New Windsor, NY 12553 | 2014-05-07 |
1427478114 | Julie Taft | Counselor | 1124 Ny Route 94, Suite 201, New Windsor, NY 12553 | 2014-04-21 |
1699199158 | Jessica G Veroline | Social Worker | 930 Raz Avenue, Arc of Orange County New Windsor Ple, New Windsor, NY 12553 | 2014-02-04 |
1316374762 | Aggies Full Beauty Salon | General Acute Care Hospital | 420 State Route 32, Vails Gate, NY 12553 | 2013-10-01 |
Find all providers in zip 12553 |
Taxonomy Code | 363LA2200X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Adult Health |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1568002038 | Kaitlyn Ellert | Nurse Practitioner | 92 Old Route 9w Ste 100, New Windsor, NY 12553-5485 | 2020-01-13 |
1053715862 | Kathleen Power Beigh | Nurse Practitioner | 3078 Route 9w, New Windsor, NY 12553-6751 | 2014-10-22 |
1508122508 | Kay Keise | Nurse Practitioner | 3141 Route 9w, Ste 100, New Windsor, NY 12553-6709 | 2012-04-04 |
1083902902 | Patricia Ann Rainaldi | Nurse Practitioner | 575 Hudson Valley Ave, New Windsor, NY 12553-4747 | 2011-07-12 |
1811203045 | Laura Woods | Nurse Practitioner | 3068 Route 9w Ste 200, New Windsor, NY 12553 | 2010-08-25 |
1164672127 | Cynthia Maggio-silverman | Nurse Practitioner | 3078 Us Route 9w, New Windsor, NY 12553-6751 | 2008-09-26 |
1023272762 | Sabrina N Stent | Nurse Practitioner | 575 Hudson Valley Ave, Suite 200, New Windsor, NY 12553-4747 | 2008-07-11 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1104427871 | Tammie Kae Copp | Nurse Practitioner | 8266 Casson Rd, Lindley, NY 14858-9697 | 2020-11-08 |
1770184673 | Annette Virosami | Nurse Practitioner | 890 Trinity Ave Apt 8d, Bronx, NY 10456-7419 | 2020-11-06 |
1972104958 | Jonathan Dillera Nietes | Nurse Practitioner | 4411 Macnish St Apt 1g, Elmhurst, NY 11373-3609 | 2020-11-05 |
1407457088 | Sanjana Kumari | Nurse Practitioner | 62 Albertson Pl, Mineola, NY 11501-4601 | 2020-11-02 |
1780284927 | Hannah Catan | Nurse Practitioner | 473 W 158th St Apt 10, New York, NY 10032-5361 | 2020-10-27 |
1700486248 | Amandeep Kaur | Nurse Practitioner | 7638 270th St, New Hyde Park, NY 11040-1418 | 2020-10-26 |
1861091324 | Stacey M Jantsch | Nurse Practitioner | 8237 Cicero Mills Rd, Cicero, NY 13039-8344 | 2020-10-25 |
1871192468 | Adult Health Np House Calls, PC | Nurse Practitioner | 7954 Transit Rd # 134, Williamsville, NY 14221-4117 | 2020-10-23 |
1104425891 | Tze-hsuan Chao | Nurse Practitioner | 3916 Prince St Ste 257, Flushing, NY 11354-5367 | 2020-10-22 |
1992304968 | Nicholas Robinson | Nurse Practitioner | 295 Essjay, Williamsville, NY 14221 | 2020-10-21 |
Find all providers with the same taxonomy |
City | NEW WINDSOR |
Zip Code | 12553 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.