Provider Demographics
NPI:1053641217
Name:MARIN, VILMA (RN)
Entity Type:Individual
Prefix:MS
First Name:VILMA
Middle Name:
Last Name:MARIN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 ENDICOTT STREET
Mailing Address - Street 2:
Mailing Address - City:CONGERS
Mailing Address - State:NY
Mailing Address - Zip Code:10920
Mailing Address - Country:US
Mailing Address - Phone:845-521-2637
Mailing Address - Fax:
Practice Address - Street 1:33 ENDICOTT ST
Practice Address - Street 2:
Practice Address - City:CONGERS
Practice Address - State:NY
Practice Address - Zip Code:10920-1905
Practice Address - Country:US
Practice Address - Phone:845-521-2637
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-11
Last Update Date:2010-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY366701163WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0200XNursing Service ProvidersRegistered NursePediatrics