Provider Demographics
NPI:1437472735
Name:FEHN, MARISA JEAN (PHARM D)
Entity Type:Individual
Prefix:
First Name:MARISA
Middle Name:JEAN
Last Name:FEHN
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:MARISA
Other - Middle Name:JEAN
Other - Last Name:GUARINI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARM D
Mailing Address - Street 1:481 S WELLWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:LINDENHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11757-4937
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:481 S WELLWOOD AVE
Practice Address - Street 2:
Practice Address - City:LINDENHURST
Practice Address - State:NY
Practice Address - Zip Code:11757-4937
Practice Address - Country:US
Practice Address - Phone:631-678-8558
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-01
Last Update Date:2023-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY053326183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist