Provider Demographics
NPI:1497811863
Name:SZITANKO, MARLENA KATHLEEN (LIC AC)
Entity Type:Individual
Prefix:MS
First Name:MARLENA
Middle Name:KATHLEEN
Last Name:SZITANKO
Suffix:
Gender:F
Credentials:LIC AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:170 HWY 35
Mailing Address - Street 2:
Mailing Address - City:RED BANK
Mailing Address - State:NJ
Mailing Address - Zip Code:07701-5929
Mailing Address - Country:US
Mailing Address - Phone:732-741-5772
Mailing Address - Fax:732-741-5778
Practice Address - Street 1:170 HWY 35
Practice Address - Street 2:
Practice Address - City:RED BANK
Practice Address - State:NJ
Practice Address - Zip Code:07701-5929
Practice Address - Country:US
Practice Address - Phone:732-741-5772
Practice Address - Fax:732-741-5778
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-29
Last Update Date:2011-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MZ00076600171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist