Provider Demographics
NPI:1598481905
Name:MARLIN, TAYLOR RETHWISCH
Entity Type:Individual
Prefix:MISS
First Name:TAYLOR
Middle Name:RETHWISCH
Last Name:MARLIN
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 1:200 EDELWEISS DR
Mailing Address - Street 2:
Mailing Address - City:WEXFORD
Mailing Address - State:PA
Mailing Address - Zip Code:15090-9441
Mailing Address - Country:US
Mailing Address - Phone:724-719-0002
Mailing Address - Fax:
Practice Address - Street 1:2719 BRODHEAD RD
Practice Address - Street 2:
Practice Address - City:ALIQUIPPA
Practice Address - State:PA
Practice Address - Zip Code:15001-2793
Practice Address - Country:US
Practice Address - Phone:724-378-4411
Practice Address - Fax:724-378-2486
Is Sole Proprietor?:No
Enumeration Date:2022-10-17
Last Update Date:2022-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP456138183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist