Wallace, Marissa Leanne

Wallace, Marissa Leanne is an sole proprietor health care provider with primary practice located at 3078 Route 9W Ste 100 , New Windsor NY 12553-6751. She recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Registered Nurse, Physician Assistants & Advanced Practice Nursing Providers / Adult Health. Physician Assistants & Advanced Practice Nursing Providers / Adult Health is her primary health care specialty. Wallace, Marissa Leanne can be contacted via phone (845) 561-3310.

Contact Information

Primary practice address
3078 Route 9W Ste 100 New Windsor NY 12553-6751
Phone: (845) 561-3310
Fax: (845) 561-8728
Website:
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Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Registered Nurse 163W00000X 653689-1 New York
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 363LA2200X F308236 New York

Profile Details

NPI number 1689932360
LBN Legal business name Wallace, Marissa Leanne
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 1st, 2012
Last updated Jul 21st, 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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