Marisa Mottley

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

731527 Issued in NY

Practice address

102 Cumberland Walk Apt 12H
Brooklyn, NY 11205-2119

Phone

(646) 377-4839

NPI assigned

Jan 27, 2020

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1580083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580083200000",
    "number": "1104457456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 CUMBERLAND WALK APT 12H",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112052119",
            "telephone_number": "646-377-4839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 CUMBERLAND WALK APT 12H",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112052119",
            "telephone_number": "646-377-4839"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOTTLEY",
        "first_name": "MARISA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-01-27",
        "last_updated": "2020-01-27",
        "certification_date": "2020-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WS0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, School",
            "state": "NY",
            "license": "731527",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "731527",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Motiv8 BK LLC
• Shabbir Juzar Motiwalla, D.D.S
• Ferrell A Motlow, M.D.
• Motola Medical Supply Inc.
• Sergey Motov, MD
• Lindsay Mottola, LMSW
• Ruchika Moturi, MD
• Kate Motvitsky
• Elisa Mouadab, BEHAVIOR ANALYST
• Joseph P Mouallem, MD, JD

• Registered Nurse in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Registered Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.