Provider Demographics
NPI:1831795541
Name:NADAL, MARILYN C
Entity type:Individual
Prefix:
First Name:MARILYN
Middle Name:C
Last Name:NADAL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4340 WEBSTER AVE
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44512-1267
Mailing Address - Country:US
Mailing Address - Phone:330-509-1424
Mailing Address - Fax:
Practice Address - Street 1:4340 WEBSTER AVE
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44512-1267
Practice Address - Country:US
Practice Address - Phone:330-509-1424
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-08
Last Update Date:2020-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251X00000XAgenciesSupports Brokerage
No253Z00000XAgenciesIn Home Supportive Care