Provider Demographics
NPI:1326301730
Name:MARULANDA, DEBORA B
Entity Type:Individual
Prefix:
First Name:DEBORA
Middle Name:B
Last Name:MARULANDA
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 1:60 CHARLES LINDBERGH BLVD
Mailing Address - Street 2:100
Mailing Address - City:UNIONDALE
Mailing Address - State:NY
Mailing Address - Zip Code:11553-3653
Mailing Address - Country:US
Mailing Address - Phone:516-227-8645
Mailing Address - Fax:
Practice Address - Street 1:60 CHARLES LINDBERGH BLVD
Practice Address - Street 2:
Practice Address - City:UNIONDALE
Practice Address - State:NY
Practice Address - Zip Code:11553-9856
Practice Address - Country:US
Practice Address - Phone:516-227-8645
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-20
Last Update Date:2012-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator