Provider Demographics
NPI:1639303019
Name:HERSH, MARNINAH (RN)
Entity Type:Individual
Prefix:
First Name:MARNINAH
Middle Name:
Last Name:HERSH
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3616 HENRY HUDSON PKWY E
Mailing Address - Street 2:APT 2IS
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10463-1505
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2500 JOHNSON AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10463-4925
Practice Address - Country:US
Practice Address - Phone:718-884-7252
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-13
Last Update Date:2009-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY584019163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse