Provider Demographics
NPI:1053068478
Name:MARZOUK, NERMIN
Entity Type:Individual
Prefix:
First Name:NERMIN
Middle Name:
Last Name:MARZOUK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7319 69TH ST
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:NY
Mailing Address - Zip Code:11385-7111
Mailing Address - Country:US
Mailing Address - Phone:646-249-3807
Mailing Address - Fax:
Practice Address - Street 1:7319 69TH ST
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:NY
Practice Address - Zip Code:11385-7111
Practice Address - Country:US
Practice Address - Phone:646-249-3807
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-05
Last Update Date:2022-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist