Provider Demographics
NPI:1003959735
Name:YANOVER, MARIANNA (ND, LAC)
Entity Type:Individual
Prefix:DR
First Name:MARIANNA
Middle Name:
Last Name:YANOVER
Suffix:
Gender:F
Credentials:ND, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1159 BRIGHTON BEACH AVE
Mailing Address - Street 2:SUITE 4J
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-5961
Mailing Address - Country:US
Mailing Address - Phone:718-490-7600
Mailing Address - Fax:
Practice Address - Street 1:1300 POST RD E
Practice Address - Street 2:
Practice Address - City:WESTPORT
Practice Address - State:CT
Practice Address - Zip Code:06880-5537
Practice Address - Country:US
Practice Address - Phone:203-255-5005
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002569-1171100000X
CT000234171100000X
CT000264175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered171100000XOther Service ProvidersAcupuncturist
Not Answered175F00000XOther Service ProvidersNaturopath