Maryanna Domenic Apn

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

MARYANNA DOMENIC APN

Doing business as

Domenic Psychiatry

Practice address

45 Perry St Unit 2
Chester, NJ 07930-3604

Phone

(908) 315-9913

Fax

(973) 494-5213

NPI assigned

Aug 1, 2024

Last updated

Sep 2, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Maryanna Vrettos Domenic, MSN, APN, PMHNP-BCNPI 1689306433

Title

Psychiatric Nurse Practitioner

Phone

(908) 315-9913

Specialties & licenses 1

Addresses

Other names 1

• Domenic Psychiatry Doing business as

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Maryanna Vrettos Domenic

  • Psychiatric/Mental Health Nurse Practitioner
  • Chester, NJ
  • NPI 1689306433
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1722470400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1756771200000",
    "number": "1891524237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 PERRY ST UNIT 2",
            "city": "CHESTER",
            "state": "NJ",
            "postal_code": "079303604",
            "telephone_number": "908-315-9913",
            "fax_number": "973-494-5213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 PERRY ST UNIT 2",
            "city": "CHESTER",
            "state": "NJ",
            "postal_code": "079303604",
            "telephone_number": "908-315-9913",
            "fax_number": "973-494-5213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARYANNA DOMENIC APN",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-01",
        "last_updated": "2025-09-02",
        "certification_date": "2025-03-04",
        "status": "A",
        "authorized_official_last_name": "DOMENIC",
        "authorized_official_first_name": "MARYANNA",
        "authorized_official_middle_name": "VRETTOS",
        "authorized_official_title_or_position": "PSYCHIATRIC NURSE PRACTITIONER",
        "authorized_official_telephone_number": "908-315-9913",
        "authorized_official_credential": "MSN, APN, PMHNP-BC"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Domenic Psychiatry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Premalatha Manickam Sr.
• Danielle Mannino, PT, DPT
• Kathleen Marie Marino, MS CCC/SLP
• Hongmarie Martinez-Carter, PSYD
• Gladys Martinez, RN
• Mathews Supports
• Kristen Lee Mathews
• Dana Maurer, OT
• Patrick Steven McDonough, PTA
• Agnieszka McFeely, RD

• Psychiatric/Mental Health Nurse Practitioner in Chester, NJ
• Providers in Chester, NJ by specialty
• Psychiatric/Mental Health Nurse Practitioner in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.