Provider Demographics
NPI:1659947505
Name:MARAJAH, BREEANNE
Entity Type:Individual
Prefix:
First Name:BREEANNE
Middle Name:
Last Name:MARAJAH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25714 147TH RD
Mailing Address - Street 2:
Mailing Address - City:ROSEDALE
Mailing Address - State:NY
Mailing Address - Zip Code:11422-2908
Mailing Address - Country:US
Mailing Address - Phone:347-601-3101
Mailing Address - Fax:
Practice Address - Street 1:8914 PARSONS BLVD
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11432-6014
Practice Address - Country:US
Practice Address - Phone:646-276-7745
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-01
Last Update Date:2023-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker