Provider Demographics
NPI:1033471719
Name:MARSAGGI, MARYANNE (MS OF ED)
Entity Type:Individual
Prefix:MRS
First Name:MARYANNE
Middle Name:
Last Name:MARSAGGI
Suffix:
Gender:F
Credentials:MS OF ED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6424 PLEASANTVIEW ST
Mailing Address - Street 2:
Mailing Address - City:MIDDLE VILLAGE
Mailing Address - State:NY
Mailing Address - Zip Code:11379-1854
Mailing Address - Country:US
Mailing Address - Phone:718-326-5741
Mailing Address - Fax:
Practice Address - Street 1:6424 PLEASANTVIEW ST
Practice Address - Street 2:
Practice Address - City:MIDDLE VILLAGE
Practice Address - State:NY
Practice Address - Zip Code:11379-1854
Practice Address - Country:US
Practice Address - Phone:718-326-5741
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-08
Last Update Date:2012-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY842435981174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist