Provider Demographics
NPI:1891412540
Name:COMFORT, MARLENE ANN (NP)
Entity Type:Individual
Prefix:
First Name:MARLENE
Middle Name:ANN
Last Name:COMFORT
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3222 DELOOZA RD
Mailing Address - Street 2:
Mailing Address - City:PENN YAN
Mailing Address - State:NY
Mailing Address - Zip Code:14527-9304
Mailing Address - Country:US
Mailing Address - Phone:585-698-7706
Mailing Address - Fax:
Practice Address - Street 1:SOLDIERS AND SAILORS HEALTH CENTER
Practice Address - Street 2:418 NORTH MAIN STREET
Practice Address - City:PENN YAN
Practice Address - State:NY
Practice Address - Zip Code:14527
Practice Address - Country:US
Practice Address - Phone:315-536-0086
Practice Address - Fax:315-536-0658
Is Sole Proprietor?:No
Enumeration Date:2022-10-24
Last Update Date:2022-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY311002363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health