Provider Demographics
NPI:1083401384
Name:ARACHE, MARIUM MOIN (CNM, RN)
Entity type:Individual
Prefix:
First Name:MARIUM
Middle Name:MOIN
Last Name:ARACHE
Suffix:
Gender:F
Credentials:CNM, RN
Other - Prefix:
Other - First Name:MARIUM
Other - Middle Name:MOIN
Other - Last Name:HUSSAINI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:42 SEWARD DR
Mailing Address - Street 2:
Mailing Address - City:DIX HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11746-7908
Mailing Address - Country:US
Mailing Address - Phone:315-404-6935
Mailing Address - Fax:
Practice Address - Street 1:42 SEWARD DR
Practice Address - Street 2:
Practice Address - City:DIX HILLS
Practice Address - State:NY
Practice Address - Zip Code:11746-7908
Practice Address - Country:US
Practice Address - Phone:315-404-6935
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-22
Last Update Date:2025-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
176B00000X, 367A00000X
NY779820163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No176B00000XOther Service ProvidersMidwife
No163W00000XNursing Service ProvidersRegistered Nurse