Provider Demographics
NPI:1417207267
Name:MARRONE, ELLEN L (RN CDE)
Entity Type:Individual
Prefix:MRS
First Name:ELLEN
Middle Name:L
Last Name:MARRONE
Suffix:
Gender:F
Credentials:RN CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 OAKNOLL CT
Mailing Address - Street 2:
Mailing Address - City:ELMA
Mailing Address - State:NY
Mailing Address - Zip Code:14059-8904
Mailing Address - Country:US
Mailing Address - Phone:716-655-3819
Mailing Address - Fax:
Practice Address - Street 1:120 OAKNOLL CRT
Practice Address - Street 2:
Practice Address - City:ELMA
Practice Address - State:NY
Practice Address - Zip Code:14059
Practice Address - Country:US
Practice Address - Phone:716-655-3819
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-19
Last Update Date:2012-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY392152163WD0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator