Provider Demographics
NPI:1710302864
Name:SIEGLER LEDERMAN, MARCY
Entity Type:Individual
Prefix:MRS
First Name:MARCY
Middle Name:
Last Name:SIEGLER LEDERMAN
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 1:9660 W BAY HARBOR DR
Mailing Address - Street 2:APT 2F
Mailing Address - City:BAY HARBOR ISLANDS
Mailing Address - State:FL
Mailing Address - Zip Code:33154-2050
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:735 NE 125TH ST
Practice Address - Street 2:APT 2F
Practice Address - City:NORTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33161-5611
Practice Address - Country:US
Practice Address - Phone:305-576-6550
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-26
Last Update Date:2014-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker