Provider Demographics
NPI:1043611924
Name:SHAIINA MARSTON
Entity Type:Organization
Organization Name:SHAIINA MARSTON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED NURSE
Authorized Official - Prefix:MS
Authorized Official - First Name:SHAIINA
Authorized Official - Middle Name:KHITANYA
Authorized Official - Last Name:MARSTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-304-4714
Mailing Address - Street 1:206 WHALEY ST
Mailing Address - Street 2:
Mailing Address - City:FREEPORT
Mailing Address - State:NY
Mailing Address - Zip Code:11520-4223
Mailing Address - Country:US
Mailing Address - Phone:516-304-4714
Mailing Address - Fax:
Practice Address - Street 1:206 WHALEY ST
Practice Address - Street 2:
Practice Address - City:FREEPORT
Practice Address - State:NY
Practice Address - Zip Code:11520-4223
Practice Address - Country:US
Practice Address - Phone:516-304-4714
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-10
Last Update Date:2014-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY683949-1251J00000X, 283Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
No283Q00000XHospitalsPsychiatric Hospital