Provider Demographics
NPI:1134151749
Name:MARCELIN, KERLINE (MD)
Entity type:Individual
Prefix:DR
First Name:KERLINE
Middle Name:
Last Name:MARCELIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2050 EAST MAIN STREET
Mailing Address - Street 2:SUITE 1-R4
Mailing Address - City:CORTLANDT MANOR
Mailing Address - State:NY
Mailing Address - Zip Code:10567
Mailing Address - Country:US
Mailing Address - Phone:914-737-6360
Mailing Address - Fax:914-736-7935
Practice Address - Street 1:2050 EAST MAIN STREET
Practice Address - Street 2:SUITE 1-R4
Practice Address - City:CORTLANDT MANOR
Practice Address - State:NY
Practice Address - Zip Code:10567
Practice Address - Country:US
Practice Address - Phone:914-737-6360
Practice Address - Fax:914-736-7935
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2022-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY206721207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02171608Medicaid
NY021716608Medicaid
NYH05959Medicare UPIN
NY0593ARMedicare ID - Type Unspecified
NY02171608Medicaid