Provider Demographics
NPI:1922230028
Name:GARRIDO, MARIE C (NP)
Entity Type:Individual
Prefix:MS
First Name:MARIE
Middle Name:C
Last Name:GARRIDO
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MS
Other - First Name:MARIE
Other - Middle Name:GLEASON
Other - Last Name:GARRIDO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:NP
Mailing Address - Street 1:257 LAFAYETTE AVE
Mailing Address - Street 2:SUITE 330
Mailing Address - City:SUFFERN
Mailing Address - State:NY
Mailing Address - Zip Code:10901-4830
Mailing Address - Country:US
Mailing Address - Phone:845-368-8808
Mailing Address - Fax:845-368-5608
Practice Address - Street 1:20 GRAND ST
Practice Address - Street 2:3RD FLOOR
Practice Address - City:WARWICK
Practice Address - State:NY
Practice Address - Zip Code:10990-1035
Practice Address - Country:US
Practice Address - Phone:845-987-3952
Practice Address - Fax:845-987-5979
Is Sole Proprietor?:No
Enumeration Date:2009-08-23
Last Update Date:2011-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF305237-1363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health