Marisa Borek, NPP

Primary specialty

Adult Psychiatric/Mental Health Clinical Nurse SpecialistTaxonomy code 364SP0809X

License

F400426 Issued in NY

Practice address

15 Brewster LN
East Setauket, NY 11733-2921

Phone

(631) 834-7119

NPI assigned

Nov 23, 2011

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Marisa Borek Former name

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": "1322006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609804800000",
    "number": "1881961530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 BREWSTER LN",
            "city": "EAST SETAUKET",
            "state": "NY",
            "postal_code": "117332921",
            "telephone_number": "631-834-7119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 BREWSTER LN",
            "city": "EAST SETAUKET",
            "state": "NY",
            "postal_code": "117332921",
            "telephone_number": "631-834-7119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOREK",
        "first_name": "MARISA",
        "credential": "NPP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-11-23",
        "last_updated": "2021-01-05",
        "certification_date": "2020-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SP0809X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health, Adult",
            "state": "NY",
            "license": "F400426",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARISA",
            "last_name": "BOREK",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Blue Harbor Medical PC
• Joyce D Boffert, DC
• Chelsey Lenka Boguslawski, MMS, PA-C
• Debra Bonamassa
• Janet Boppe
• Mark Gregory Borek, M.D.
• Lindsay Bosch, M.S.
• George James Bouklas, PH.D
• Nariman Boyle, M.D.
• Ryan Bozzello, M.A. CCC-SLP

• Adult Psychiatric/Mental Health Clinical Nurse Specialist in East Setauket, NY
• Providers in East Setauket, NY by specialty
• Adult Psychiatric/Mental Health Clinical Nurse Specialist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2021; 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.