Provider Demographics
NPI:1447413117
Name:MARAJ, MARILYN E
Entity Type:Individual
Prefix:MS
First Name:MARILYN
Middle Name:E
Last Name:MARAJ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9207 103RD AVE
Mailing Address - Street 2:
Mailing Address - City:OZONE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11417-3113
Mailing Address - Country:US
Mailing Address - Phone:347-449-4002
Mailing Address - Fax:
Practice Address - Street 1:9207 103RD AVENUE
Practice Address - Street 2:
Practice Address - City:OZONE PARK
Practice Address - State:NY
Practice Address - Zip Code:11417-3113
Practice Address - Country:US
Practice Address - Phone:347-449-4023
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-03
Last Update Date:2008-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY291385164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse