Provider Demographics
NPI:1699043885
Name:NAVARRO, MARJORIE (LAC)
Entity Type:Individual
Prefix:
First Name:MARJORIE
Middle Name:
Last Name:NAVARRO
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 STERLING PL APT 4I
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11217-3338
Mailing Address - Country:US
Mailing Address - Phone:646-481-4228
Mailing Address - Fax:
Practice Address - Street 1:90 BROAD ST FL 2
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10004-3313
Practice Address - Country:US
Practice Address - Phone:646-481-4228
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-02
Last Update Date:2023-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOM000252171100000X
NY004628171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist