Provider Demographics
NPI:1427210012
Name:NUNEZ, MARIANA DE JESUS (MD)
Entity type:Individual
Prefix:DR
First Name:MARIANA
Middle Name:DE JESUS
Last Name:NUNEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:MARIANA
Other - Middle Name:
Other - Last Name:OTTAVIANO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:50 DAYTON LN
Mailing Address - Street 2:SUITE 202
Mailing Address - City:PEEKSKILL
Mailing Address - State:NY
Mailing Address - Zip Code:10566-2859
Mailing Address - Country:US
Mailing Address - Phone:914-739-0087
Mailing Address - Fax:914-737-1714
Practice Address - Street 1:1980 CROMPOND RD
Practice Address - Street 2:
Practice Address - City:CORTLANDT MANOR
Practice Address - State:NY
Practice Address - Zip Code:10567-4144
Practice Address - Country:US
Practice Address - Phone:914-734-3600
Practice Address - Fax:914-734-3601
Is Sole Proprietor?:No
Enumeration Date:2008-06-25
Last Update Date:2012-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY250395207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine