Provider Demographics
NPI:1811692866
Name:CELESTINE, MARLON
Entity type:Individual
Prefix:
First Name:MARLON
Middle Name:
Last Name:CELESTINE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5724 JOAN LN
Mailing Address - Street 2:
Mailing Address - City:CAMP SPRINGS
Mailing Address - State:MD
Mailing Address - Zip Code:20748-4744
Mailing Address - Country:US
Mailing Address - Phone:202-641-6069
Mailing Address - Fax:
Practice Address - Street 1:1667 GOOD HOPE RD SE APT 316
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20020-4771
Practice Address - Country:US
Practice Address - Phone:240-289-3482
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-31
Last Update Date:2023-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant