Provider Demographics
NPI:1407504756
Name:CHEN, MARIELLE ORQUIN (FNP-BC)
Entity Type:Individual
Prefix:
First Name:MARIELLE
Middle Name:ORQUIN
Last Name:CHEN
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:724 127TH ST
Mailing Address - Street 2:
Mailing Address - City:COLLEGE POINT
Mailing Address - State:NY
Mailing Address - Zip Code:11356-1244
Mailing Address - Country:US
Mailing Address - Phone:347-636-8342
Mailing Address - Fax:
Practice Address - Street 1:724 127TH ST
Practice Address - Street 2:
Practice Address - City:COLLEGE POINT
Practice Address - State:NY
Practice Address - Zip Code:11356-1244
Practice Address - Country:US
Practice Address - Phone:347-636-8342
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-15
Last Update Date:2022-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF346524-01363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner