Provider Demographics
NPI:1710529201
Name:MESHEL, MARCIA JOAN
Entity Type:Individual
Prefix:MS
First Name:MARCIA
Middle Name:JOAN
Last Name:MESHEL
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 1:5809 246TH CRES
Mailing Address - Street 2:
Mailing Address - City:DOUGLASTON
Mailing Address - State:NY
Mailing Address - Zip Code:11362-2053
Mailing Address - Country:US
Mailing Address - Phone:718-281-9707
Mailing Address - Fax:718-281-9707
Practice Address - Street 1:5809 246TH CRES
Practice Address - Street 2:
Practice Address - City:DOUGLASTON
Practice Address - State:NY
Practice Address - Zip Code:11362-2053
Practice Address - Country:US
Practice Address - Phone:718-281-9707
Practice Address - Fax:718-281-9707
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-16
Last Update Date:2019-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY828364981251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)