Provider Demographics
NPI:1700417326
Name:PRINE, MARC (MSED)
Entity Type:Individual
Prefix:
First Name:MARC
Middle Name:
Last Name:PRINE
Suffix:
Gender:M
Credentials:MSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 SYCAMORE DR
Mailing Address - Street 2:
Mailing Address - City:HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:12538-2117
Mailing Address - Country:US
Mailing Address - Phone:845-240-3121
Mailing Address - Fax:
Practice Address - Street 1:167 MYERS CORNERS RD STE 104
Practice Address - Street 2:
Practice Address - City:WAPPINGERS FALLS
Practice Address - State:NY
Practice Address - Zip Code:12590-3870
Practice Address - Country:US
Practice Address - Phone:845-298-2090
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-01
Last Update Date:2020-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist