Provider Demographics
NPI:1659721827
Name:ZARCZYNSKI, MARISA J (MPS)
Entity Type:Individual
Prefix:
First Name:MARISA
Middle Name:J
Last Name:ZARCZYNSKI
Suffix:
Gender:F
Credentials:MPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:68 DEBEVOISE STREET
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11206-9900
Mailing Address - Country:US
Mailing Address - Phone:718-963-4430
Mailing Address - Fax:
Practice Address - Street 1:209 CLINTON AVE
Practice Address - Street 2:APT#10G
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11205-3573
Practice Address - Country:US
Practice Address - Phone:917-676-8015
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-17
Last Update Date:2016-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare