Boulukos, Marisa

Boulukos, Marisa is an sole proprietor health care provider with primary practice located at 75 Grand Ave , Massapequa NY 11758-4905. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Boulukos, Marisa can be contacted via phone (516) 799-3202.

Contact Information

Primary practice address
75 Grand Ave Massapequa NY 11758-4905
Phone: (516) 799-3202
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X R042317-1 New York

Profile Details

NPI number 1437203320
LBN Legal business name Boulukos, Marisa
Credentials LCSWR
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 22nd, 2007
Last updated Jul 8th, 2007 - about 17 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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