Provider Demographics
NPI:1972864791
Name:BEHARRY, MARISA E (MS ED)
Entity Type:Individual
Prefix:MRS
First Name:MARISA
Middle Name:E
Last Name:BEHARRY
Suffix:
Gender:F
Credentials:MS ED
Other - Prefix:MRS
Other - First Name:MARISA
Other - Middle Name:E
Other - Last Name:BEHARRY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS ED
Mailing Address - Street 1:360 CLINTON AVE APT 4G
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11238-1170
Mailing Address - Country:US
Mailing Address - Phone:347-406-3402
Mailing Address - Fax:
Practice Address - Street 1:360 CLINTON AVE .
Practice Address - Street 2:4G
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11238
Practice Address - Country:US
Practice Address - Phone:347-406-3402
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-07
Last Update Date:2012-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor