Marilyn J Ejercito, RN, BSN, MS

Primary specialty

Administrator Registered NurseTaxonomy code 163WA2000X

License

297319-1 Issued in NY

Practice address

124 Main St
Goshen, NY 10924-2124

Phone

(845) 291-2330

Fax

(845) 291-2380

NPI assigned

Oct 6, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor on Science - Nursing, Master of Science, Registered Nurse

State licenses

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

{
    "created_epoch": "1317859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317859200000",
    "number": "1649554809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 MAIN ST.",
            "city": "GOSHEN",
            "state": "NY",
            "postal_code": "10924",
            "telephone_number": "845-291-2330",
            "fax_number": "845-291-2380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 MAIN ST",
            "city": "GOSHEN",
            "state": "NY",
            "postal_code": "109242124",
            "telephone_number": "845-291-2330",
            "fax_number": "845-291-2380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EJERCITO",
        "first_name": "MARILYN",
        "middle_name": "J",
        "name_prefix": "Ms.",
        "credential": "RN, BSN, MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-06",
        "last_updated": "2011-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WA2000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Administrator",
            "state": "NY",
            "license": "297319-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laura Jean Dumser
• Ann Elizabeth Dunlevy, CASAC-T
• Sharon R Durr, COTA
• Cassandra L Eberhard-Leal, LCSW
• Robyn Eherts
• Elant at Goshen
• Elant at Goshen, Inc.
• Mark Elba, LCSW
• Pamela Eliasson, LCSW
• David J Ellis, M.D.

• Administrator Registered Nurse in Goshen, NY
• Providers in Goshen, NY by specialty
• Administrator Registered Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2011; 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.