Provider Demographics
NPI:1619287711
Name:MARSEILLE, MARIE DANIE (LPN)
Entity Type:Individual
Prefix:MRS
First Name:MARIE DANIE
Middle Name:
Last Name:MARSEILLE
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 1:21 MANORVIEW WAY
Mailing Address - Street 2:
Mailing Address - City:MANORVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11949-2974
Mailing Address - Country:US
Mailing Address - Phone:631-325-1872
Mailing Address - Fax:
Practice Address - Street 1:21 MANORVIEW WAY
Practice Address - Street 2:
Practice Address - City:MANORVILLE
Practice Address - State:NY
Practice Address - Zip Code:11949-2974
Practice Address - Country:US
Practice Address - Phone:631-325-1872
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-07
Last Update Date:2010-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY299992164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse