Provider Demographics
NPI:1922344910
Name:MARZAN, CINDY MICHELLE (LPN)
Entity Type:Individual
Prefix:
First Name:CINDY
Middle Name:MICHELLE
Last Name:MARZAN
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:155 NORTH ST
Mailing Address - Street 2:
Mailing Address - City:MEDINA
Mailing Address - State:NY
Mailing Address - Zip Code:14103-1324
Mailing Address - Country:US
Mailing Address - Phone:585-331-2181
Mailing Address - Fax:
Practice Address - Street 1:155 NORTH ST
Practice Address - Street 2:
Practice Address - City:MEDINA
Practice Address - State:NY
Practice Address - Zip Code:14103-1324
Practice Address - Country:US
Practice Address - Phone:585-331-2181
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-18
Last Update Date:2012-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY297191164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse