Provider Demographics
NPI:1043453251
Name:MANIERAM-ARJUNE, MARANDA (NP)
Entity Type:Individual
Prefix:MRS
First Name:MARANDA
Middle Name:
Last Name:MANIERAM-ARJUNE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:POB 1061
Mailing Address - Street 2:
Mailing Address - City:PORT WASHINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11050-1061
Mailing Address - Country:US
Mailing Address - Phone:516-629-2467
Mailing Address - Fax:516-629-2027
Practice Address - Street 1:100 PORT WASHINGTON BLVD.
Practice Address - Street 2:SUITE 105
Practice Address - City:ROSLYN
Practice Address - State:NY
Practice Address - Zip Code:11576-1353
Practice Address - Country:US
Practice Address - Phone:516-390-9640
Practice Address - Fax:516-390-9650
Is Sole Proprietor?:No
Enumeration Date:2009-04-17
Last Update Date:2009-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY305088363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner