Provider Demographics
NPI:1376005884
Name:MOLINA, MARIANELA (RN)
Entity Type:Individual
Prefix:
First Name:MARIANELA
Middle Name:
Last Name:MOLINA
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 1:45 CIRCLE DR
Mailing Address - Street 2:
Mailing Address - City:HOPEWELL JUNCTION
Mailing Address - State:NY
Mailing Address - Zip Code:12533-5830
Mailing Address - Country:US
Mailing Address - Phone:845-269-8957
Mailing Address - Fax:
Practice Address - Street 1:45 CIRCLE DR
Practice Address - Street 2:
Practice Address - City:HOPEWELL JUNCTION
Practice Address - State:NY
Practice Address - Zip Code:12533-5830
Practice Address - Country:US
Practice Address - Phone:845-269-8957
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-03
Last Update Date:2019-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY746677163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse