Provider Demographics
NPI:1932444585
Name:BRIGHT, MARICE
Entity Type:Individual
Prefix:MRS
First Name:MARICE
Middle Name:
Last Name:BRIGHT
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 1:421 STATE ROUTE 95
Mailing Address - Street 2:
Mailing Address - City:MOIRA
Mailing Address - State:NY
Mailing Address - Zip Code:12957-2806
Mailing Address - Country:US
Mailing Address - Phone:518-529-6325
Mailing Address - Fax:
Practice Address - Street 1:23 HUSKIE LN
Practice Address - Street 2:
Practice Address - City:MALONE
Practice Address - State:NY
Practice Address - Zip Code:12953-2450
Practice Address - Country:US
Practice Address - Phone:518-483-6420
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-10
Last Update Date:2012-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist