Provider Demographics
NPI:1700219755
Name:MARCELIN, FLORE LYNDA (RN)
Entity Type:Individual
Prefix:MS
First Name:FLORE
Middle Name:LYNDA
Last Name:MARCELIN
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 1:21319A HILLSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:QUEENS VILLAGE
Mailing Address - State:NY
Mailing Address - Zip Code:11427-1813
Mailing Address - Country:US
Mailing Address - Phone:646-651-3962
Mailing Address - Fax:
Practice Address - Street 1:21319A HILLSIDE AVE
Practice Address - Street 2:
Practice Address - City:QUEENS VILLAGE
Practice Address - State:NY
Practice Address - Zip Code:11427-1813
Practice Address - Country:US
Practice Address - Phone:646-651-3962
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-13
Last Update Date:2013-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY520360-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse