Provider Demographics
NPI:1134482565
Name:TITUS-PRESCOTT, MARCIA ANITA (RN)
Entity Type:Individual
Prefix:MRS
First Name:MARCIA
Middle Name:ANITA
Last Name:TITUS-PRESCOTT
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 1:2017 SCHENECTADY AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11234-3130
Mailing Address - Country:US
Mailing Address - Phone:718-677-6235
Mailing Address - Fax:718-236-8456
Practice Address - Street 1:40 RECTOR ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10006-1705
Practice Address - Country:US
Practice Address - Phone:212-385-3030
Practice Address - Fax:212-385-2380
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-20
Last Update Date:2012-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY459265163WC1500X, 163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
No163WC1500XNursing Service ProvidersRegistered NurseCommunity Health