Provider Demographics
NPI:1437569597
Name:WELDEN, MARLENE
Entity Type:Individual
Prefix:
First Name:MARLENE
Middle Name:
Last Name:WELDEN
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:MARLENE
Other - Middle Name:PATRICIA
Other - Last Name:HILL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN
Mailing Address - Street 1:1 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:CENTRAL ISLIP
Mailing Address - State:NY
Mailing Address - Zip Code:11722
Mailing Address - Country:US
Mailing Address - Phone:631-348-5050
Mailing Address - Fax:
Practice Address - Street 1:1 BROADWAY AVE
Practice Address - Street 2:
Practice Address - City:CENTRAL ISLIP
Practice Address - State:NY
Practice Address - Zip Code:11722-2436
Practice Address - Country:US
Practice Address - Phone:631-348-5050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-29
Last Update Date:2014-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY342605-1163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool