Provider Demographics
NPI:1881037075
Name:SHU, MARLA ANN (DO)
Entity Type:Individual
Prefix:MS
First Name:MARLA
Middle Name:ANN
Last Name:SHU
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1ST AVENUE AT 16TH STREET
Mailing Address - Street 2:BETH ISRAEL MEDICAL CENTER
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003
Mailing Address - Country:US
Mailing Address - Phone:347-323-3087
Mailing Address - Fax:
Practice Address - Street 1:1ST AVENUE AT 16TH STREET
Practice Address - Street 2:BETH ISRAEL MEDICAL CENTER
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003
Practice Address - Country:US
Practice Address - Phone:347-323-3087
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-08
Last Update Date:2013-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program