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MARYELLEN GREGORY HAMMILL
Psychiatric/Mental Health >> Nurse Practitioner >> Physician Assistants & Advanced Practice Nursing ProvidersRegistrant NPI Number: 1740879907
Individual Registrant: MARYELLEN GREGORY HAMMILL
Gender: F
Sole Proprietor
Gender: F
Sole Proprietor
Location and contact information for practice:
21 FULTON WALK BREEZY POINT, NY 11697-1718 US
Tel: 917-561-1379 Fax: --
Tel: 917-561-1379 Fax: --
Contact information for business:
21 FULTON WALK BREEZY POINT, NY 11697-1718 US
Tel: 917-561-1379 Fax: --
Tel: 917-561-1379 Fax: --
Registration Information:
NPI: 1740879907
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 363LP0808X | Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner Psychiatric/Mental Health | NY | F403272-01 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
