Provider Demographics
NPI:1962502674
Name:GOLDYN, MARIANNE (RN)
Entity Type:Individual
Prefix:MS
First Name:MARIANNE
Middle Name:
Last Name:GOLDYN
Suffix:
Gender:F
Credentials:RN
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Mailing Address - Street 1:COMMUNITY SUPPORT SERVICES INC
Mailing Address - Street 2:150 CROSS STREET
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44311
Mailing Address - Country:US
Mailing Address - Phone:330-253-9388
Mailing Address - Fax:330-376-6726
Practice Address - Street 1:COMMUNITY SUPPORT SERVICES INC
Practice Address - Street 2:150 CROSS STREET
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44311
Practice Address - Country:US
Practice Address - Phone:330-253-9388
Practice Address - Fax:330-376-6726
Is Sole Proprietor?:No
Enumeration Date:2006-09-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OHCOA02474NS364S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
S79486Medicare UPIN