Marvin Louie Custodio Enerio, | |
1468 Madison Ave, New York, NY 10029-6508 | |
(347) 862-8973 | |
Not Available |
Full Name | Marvin Louie Custodio Enerio |
---|---|
Gender | Male |
Speciality | Nurse Practitioner |
Experience | 3 Years |
Location | 1468 Madison Ave, New York, New York |
Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1952065260 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
363LP0808X | Nurse Practitioner - Psychiatric/mental Health | 403815 (New York) | Primary |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Bailey House Inc | 4385870203 | 3 |
Entity Name | Housing Works Services Inc. |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1831122977 PECOS PAC ID: 6204008923 Enrollment ID: O20111004000024 |
Entity Name | Bailey House Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1083820583 PECOS PAC ID: 4385870203 Enrollment ID: O20170125003003 |
Mailing Address | Practice Location Address |
---|---|
Marvin Louie Custodio Enerio, 362 W 116th St Apt 2b, New York, NY 10026-2068 Ph: (347) 862-8973 | Marvin Louie Custodio Enerio, 1468 Madison Ave, New York, NY 10029-6508 Ph: (347) 862-8973 |
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Maureen Licursi, CPNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 161 Fort Washington Ave, 7th Floor, New York, NY 10032 Phone: 212-305-2466 | |
Ms. Brenda Dawn Slade, N.P. Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 3009 Broadway, Barnard College Health Service, New York, NY 10027 Phone: 212-854-2091 Fax: 212-854-2702 | |
Ms. Meredith Hooper Conry, N.P.P. Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 122 W 27th St, 6th Floor, New York, NY 10001 Phone: 212-691-2900 | |
Ms. Nicole Noelle Reynolds, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1275 York Ave, New York, NY 10065 Phone: 212-682-7326 | |
Mrs. Sharlene Seecharran, RN, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1275 York Ave, New York, NY 10065 Phone: 212-639-2203 | |
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