Blank, Maryellen

Blank, Maryellen is an sole proprietor health care provider with primary practice located at 170 Driftwood Dr , West Islip NY 11795-5002. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, Adult, which is considered as her primary health care specialty. Blank, Maryellen can be contacted via phone (631) 422-7362.

Contact Information

Primary practice address
170 Driftwood Dr West Islip NY 11795-5002
Phone: (631) 422-7362
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, Adult 364SP0809X 400620 New York

Profile Details

NPI number 1609930015
LBN Legal business name Blank, Maryellen
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 20th, 2006
Last updated Feb 10th, 2022 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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