Provider Demographics
NPI:1619302361
Name:MARQUEZ, ADRIENNE MARIE (MS SPED)
Entity Type:Individual
Prefix:
First Name:ADRIENNE
Middle Name:MARIE
Last Name:MARQUEZ
Suffix:
Gender:F
Credentials:MS SPED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3900 BAILEY AVE
Mailing Address - Street 2:FA
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10463-2724
Mailing Address - Country:US
Mailing Address - Phone:646-533-6266
Mailing Address - Fax:
Practice Address - Street 1:3900 BAILEY AVE
Practice Address - Street 2:FA
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10463-2724
Practice Address - Country:US
Practice Address - Phone:646-533-6266
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-12
Last Update Date:2013-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1825286174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist