Provider Demographics
NPI:1134990880
Name:MARCELIN, EDWIGE DUCEUS (SOLE PROPRIETOR)
Entity type:Individual
Prefix:
First Name:EDWIGE
Middle Name:DUCEUS
Last Name:MARCELIN
Suffix:
Gender:F
Credentials:SOLE PROPRIETOR
Other - Prefix:
Other - First Name:EDWIGE
Other - Middle Name:DUCEUS
Other - Last Name:MARCELIN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:SOLE PROPRIETOR
Mailing Address - Street 1:33 LINCOLN AVE APT 10C
Mailing Address - Street 2:
Mailing Address - City:NEW ROCHELLE
Mailing Address - State:NY
Mailing Address - Zip Code:10801-3423
Mailing Address - Country:US
Mailing Address - Phone:914-291-6257
Mailing Address - Fax:
Practice Address - Street 1:33 LINCOLN AVE APT 10C
Practice Address - Street 2:
Practice Address - City:NEW ROCHELLE
Practice Address - State:NY
Practice Address - Zip Code:10801-3423
Practice Address - Country:US
Practice Address - Phone:914-291-6257
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-11
Last Update Date:2024-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide