Provider Demographics
NPI:1912637372
Name:STIMMEL, MARNINA BAYLA (PHD)
Entity Type:Individual
Prefix:DR
First Name:MARNINA
Middle Name:BAYLA
Last Name:STIMMEL
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3230 BAINBRIDGE AVE STE C
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10467-3963
Mailing Address - Country:US
Mailing Address - Phone:201-798-5675
Mailing Address - Fax:
Practice Address - Street 1:3230 BAINBRIDGE AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10467-3963
Practice Address - Country:US
Practice Address - Phone:718-944-1832
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-16
Last Update Date:2022-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY024835103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist