Provider Demographics
NPI:1336457704
Name:VERLANDER, MARIAN
Entity Type:Individual
Prefix:MS
First Name:MARIAN
Middle Name:
Last Name:VERLANDER
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 1:357 OYSTER BAY RD
Mailing Address - Street 2:
Mailing Address - City:MILL NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11765-1212
Mailing Address - Country:US
Mailing Address - Phone:516-922-7050
Mailing Address - Fax:
Practice Address - Street 1:357 OYSTER BAY RD
Practice Address - Street 2:
Practice Address - City:MILL NECK
Practice Address - State:NY
Practice Address - Zip Code:11765-1212
Practice Address - Country:US
Practice Address - Phone:516-922-7050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-20
Last Update Date:2010-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003968101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
V672VOtherEMPIRE BLUECROSS BLUESHIELD