Provider Demographics
NPI:1588212070
Name:MARIN, JASMINE
Entity Type:Individual
Prefix:MS
First Name:JASMINE
Middle Name:
Last Name:MARIN
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 1:845 N BROADWAY
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10603-2403
Mailing Address - Country:US
Mailing Address - Phone:914-761-0600
Mailing Address - Fax:914-761-5367
Practice Address - Street 1:1 ODELL PLZ STE 1
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10701-1402
Practice Address - Country:US
Practice Address - Phone:914-237-6089
Practice Address - Fax:914-237-6099
Is Sole Proprietor?:No
Enumeration Date:2019-08-28
Last Update Date:2019-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program