Provider Demographics
NPI:1023116183
Name:SHEFLIN, MARLA S (DO)
Entity type:Individual
Prefix:DR
First Name:MARLA
Middle Name:S
Last Name:SHEFLIN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2867 BEACH DR
Mailing Address - Street 2:
Mailing Address - City:MERRICK
Mailing Address - State:NY
Mailing Address - Zip Code:11566-5119
Mailing Address - Country:US
Mailing Address - Phone:917-597-9646
Mailing Address - Fax:
Practice Address - Street 1:2867 BEACH DR
Practice Address - Street 2:
Practice Address - City:MERRICK
Practice Address - State:NY
Practice Address - Zip Code:11566-5119
Practice Address - Country:US
Practice Address - Phone:917-597-9646
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2015-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY204912207PP0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207PP0204XAllopathic & Osteopathic PhysiciansEmergency MedicinePediatric Emergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02074468Medicaid
NYG89979Medicare UPIN