Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Marvin Louie Custodio Enerio

Individual provider Psychiatric/Mental Health Nurse Practitioner · NPI 1952065260

Marvin Louie Custodio Enerio is a Nurse Practitioner in New York, New York. Qualified in 2021, 5 years ago. Practices with Bailey House Inc, a 6-clinician group and accepts Medicare assignment. Licensed in New York.

Years since qualifying
5
Licensed in
NY
In the registry since
2021
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Practice location Address checks out

1468 Madison Ave
New York, NY 10029-6508
Phone: (347) 862-8973
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X · Licence 403815 (NY)

Record details

NPI number1952065260
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedOctober 25, 2021
Last updated in NPPESFebruary 1, 2022
Certification dateFebruary 1, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Bailey House Inc — 6 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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