Martha George Marcellus

Primary specialty

Lactation Consultant (Registered Nurse)Taxonomy code 163WL0100X

License

623837-1 Issued in NY

Practice address

134 New York Ave
Freeport, NY 11520-1538

Phone

(646) 416-3820

NPI assigned

Oct 20, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other names 1

• Martha George Joseph Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• MGM Professional Care Services LLC.

  • Lactation Consultant (Registered Nurse)
  • Freeport, NY
  • NPI 1215731096
  NPD (past) Authorized official

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

{
    "created_epoch": "1476921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741737600000",
    "number": "1427509843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "134 NEW YORK AVE",
            "city": "FREEPORT",
            "state": "NY",
            "postal_code": "115201538",
            "telephone_number": "646-416-3820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "134 NEW YORK AVE",
            "city": "FREEPORT",
            "state": "NY",
            "postal_code": "115201538",
            "telephone_number": "646-416-3820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARCELLUS",
        "first_name": "MARTHA",
        "middle_name": "GEORGE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-10-20",
        "last_updated": "2025-03-12",
        "certification_date": "2025-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WM0705X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Medical-Surgical",
            "state": "NY",
            "license": "623837-1",
            "primary": false
        },
        {
            "code": "163WN0002X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Neonatal Intensive Care",
            "state": "NY",
            "license": "623837-1",
            "primary": false
        },
        {
            "code": "163WL0100X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Lactation Consultant",
            "state": "NY",
            "license": "623837-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARTHA",
            "last_name": "JOSEPH",
            "middle_name": "GEORGE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Hyitreal Maitre
• Maxo Junior Maitre
• Kathleen Marie Malizia
• Sylvia Mamani, D.O.
• Manifesting Dreams Inc
• Nadgeffrena Marcena
• Rosemary Marrugo, MS
• Janette Marsac, LMSW, RDN
• Vanessa Martinez-Mautino, LMSW
• Alexander Martinez

• Lactation Consultant (Registered Nurse) in Freeport, NY
• Providers in Freeport, NY by specialty
• Lactation Consultant (Registered Nurse) in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2025; 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.