Provider Demographics
NPI:1720164783
Name:BOGGIANO-PHILLIPS, MARILYN (RN, PNP)
Entity Type:Individual
Prefix:MS
First Name:MARILYN
Middle Name:
Last Name:BOGGIANO-PHILLIPS
Suffix:
Gender:F
Credentials:RN, PNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 STUYVESANT OVAL
Mailing Address - Street 2:APT MH
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10009-2144
Mailing Address - Country:US
Mailing Address - Phone:212-979-5310
Mailing Address - Fax:
Practice Address - Street 1:122 E 23RD ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010-4516
Practice Address - Country:US
Practice Address - Phone:212-677-7400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-31
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY38381137163WP0200X
NY337968163WP2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered163WP0200XNursing Service ProvidersRegistered NursePediatrics
Not Answered163WP2201XNursing Service ProvidersRegistered NurseAmbulatory Care