Provider Demographics
NPI:1457713760
Name:MARCHLOWSKA, DANA
Entity Type:Individual
Prefix:
First Name:DANA
Middle Name:
Last Name:MARCHLOWSKA
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:DANA
Other - Middle Name:
Other - Last Name:MARCHLOWSKA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:1469 MERRICK AVE
Mailing Address - Street 2:
Mailing Address - City:MERRICK
Mailing Address - State:NY
Mailing Address - Zip Code:11566-1602
Mailing Address - Country:US
Mailing Address - Phone:516-519-9340
Mailing Address - Fax:
Practice Address - Street 1:1469 MERRICK AVE
Practice Address - Street 2:
Practice Address - City:MERRICK
Practice Address - State:NY
Practice Address - Zip Code:11566
Practice Address - Country:US
Practice Address - Phone:516-519-9340
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-25
Last Update Date:2016-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY849925252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency