Provider Demographics
NPI:1356615330
Name:MAHARAM, MARCIA JAN (RN)
Entity type:Individual
Prefix:MS
First Name:MARCIA
Middle Name:JAN
Last Name:MAHARAM
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MS
Other - First Name:MARCIA
Other - Middle Name:JAN
Other - Last Name:MICHELSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:160 W 78TH ST
Mailing Address - Street 2:ATTN: PS 87 SCHOOL NURSE
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-6701
Mailing Address - Country:US
Mailing Address - Phone:212-678-2826
Mailing Address - Fax:212-678-5886
Practice Address - Street 1:160 W 78TH ST
Practice Address - Street 2:ATTN: PS 87 SCHOOL NURSE
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-6701
Practice Address - Country:US
Practice Address - Phone:212-678-2826
Practice Address - Fax:212-678-5886
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-08
Last Update Date:2012-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY374555-1163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool