person
Ms. Maryellen Blank, NP
Psychiatric/Mental Health Nurse Practitioner in Bay Shore, New York
NPI 1609930015

Maryellen Blank is a Psychiatric/Mental Health Nurse Practitioner based in West Islip, NY and is specialized in Psychiatric/Mental Health. Maryellen Blank practices in Bay Shore, NY and has the professional credentials of NP. The NPI Number for Maryellen Blank is 1609930015 and holds a License No. 400620 (New York).

The current practice location address for Maryellen Blank is 21 4Th Ave, Bay Shore, NY and can be reached out via phone at 631-665-6707 and via fax at 631-665-3564.

Location: 21 4Th Ave, Bay Shore, NY, 11795-5002
person
Provider Profile Details
NPI Number
1609930015
Provider Name
Maryellen Blank
Credential
NP
Provider Entity Type
Individual
Gender
Female
Address
21 4Th Ave, Bay Shore, NY, 11795-5002
Phone Number
631-665-6707
Fax Number
631-665-3564
Provider Enumeration Date
12/20/2006
Last Update Date
11/16/2024
institution
Provider Business Practice Location Address Details
Address
21 4Th Ave
City
State
Zip
11706-7908
Phone Number
631-665-6707
Fax Number
631-665-3564
person
Provider Business Mailing Address Details
Address
21 4Th Ave
City
State
Zip
11706-7908
Phone Number
631-665-6707
Fax Number
631-665-3564
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Psychiatric/Mental Health
Taxonomy
License No.
F400620-01 (New York)
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Clinical Nurse Specialist
Speciality
Psychiatric/Mental Health, Adult
Taxonomy
License No.
400620 (New York)
Definition
Definition to come...
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