Provider Demographics
NPI:1396006144
Name:MARSALA, DAWN (MS ED)
Entity Type:Individual
Prefix:
First Name:DAWN
Middle Name:
Last Name:MARSALA
Suffix:
Gender:F
Credentials:MS ED
Other - Prefix:
Other - First Name:DAWN
Other - Middle Name:
Other - Last Name:DALY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS ED
Mailing Address - Street 1:24 WINOKA DR
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON STATION
Mailing Address - State:NY
Mailing Address - Zip Code:11746-2049
Mailing Address - Country:US
Mailing Address - Phone:516-713-6310
Mailing Address - Fax:
Practice Address - Street 1:610 W 112TH ST
Practice Address - Street 2:BANK STREET FAMILY CENTER
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-1898
Practice Address - Country:US
Practice Address - Phone:212-875-4412
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-07
Last Update Date:2012-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2196683174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY2196683OtherNYS TEACHER CERTIFICATION NUMBER