Provider Demographics
NPI:1609106558
Name:MARJORIE A. ARNI LLC
Entity Type:Organization
Organization Name:MARJORIE A. ARNI LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:APRN
Authorized Official - Prefix:MS
Authorized Official - First Name:MARJORIE
Authorized Official - Middle Name:A
Authorized Official - Last Name:ARNI
Authorized Official - Suffix:
Authorized Official - Credentials:MS MA
Authorized Official - Phone:860-671-9277
Mailing Address - Street 1:PO BOX 682
Mailing Address - Street 2:
Mailing Address - City:SHARON
Mailing Address - State:CT
Mailing Address - Zip Code:06069-0682
Mailing Address - Country:US
Mailing Address - Phone:860-671-9277
Mailing Address - Fax:860-364-5718
Practice Address - Street 1:308 MAIN ST
Practice Address - Street 2:LAKEVILLE
Practice Address - City:LAKEVILLE
Practice Address - State:CT
Practice Address - Zip Code:06039-1204
Practice Address - Country:US
Practice Address - Phone:860-671-9277
Practice Address - Fax:860-364-5718
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-28
Last Update Date:2013-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001382251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
S46496Medicare UPIN