Provider Demographics
NPI:1235222787
Name:TAYLOR, MARION LYNN (MD)
Entity Type:Individual
Prefix:DR
First Name:MARION
Middle Name:LYNN
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:4 ETHEL RD
Mailing Address - Street 2:SUITE 406B
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08817-2841
Mailing Address - Country:US
Mailing Address - Phone:732-287-6362
Mailing Address - Fax:732-287-4339
Practice Address - Street 1:4 ETHEL RD
Practice Address - Street 2:SUITE 406B
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08817-2841
Practice Address - Country:US
Practice Address - Phone:732-287-6362
Practice Address - Fax:732-287-4339
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJMA46317207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJE61972Medicare UPIN
NJTA015733Medicare ID - Type Unspecified