Provider Demographics
NPI:1558693663
Name:HYMAN, MARLENE ANNE (LPN)
Entity Type:Individual
Prefix:MS
First Name:MARLENE
Middle Name:ANNE
Last Name:HYMAN
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:360A W MERRICK RD
Mailing Address - Street 2:SUITE 259
Mailing Address - City:VALLEY STREAM
Mailing Address - State:NY
Mailing Address - Zip Code:11580-5354
Mailing Address - Country:US
Mailing Address - Phone:516-209-7396
Mailing Address - Fax:516-706-1051
Practice Address - Street 1:360A W MERRICK RD
Practice Address - Street 2:SUITE 259
Practice Address - City:VALLEY STREAM
Practice Address - State:NY
Practice Address - Zip Code:11580-5354
Practice Address - Country:US
Practice Address - Phone:516-209-7396
Practice Address - Fax:516-706-1051
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-01
Last Update Date:2010-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY251927164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse