Provider Demographics
NPI:1548440688
Name:MARSEILLE, BEATRICE R (RN,APN)
Entity type:Individual
Prefix:
First Name:BEATRICE
Middle Name:R
Last Name:MARSEILLE
Suffix:
Gender:F
Credentials:RN,APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:22 S MADISON AVE
Mailing Address - Street 2:SUITE C
Mailing Address - City:SPRING VALLEY
Mailing Address - State:NY
Mailing Address - Zip Code:10977-5525
Mailing Address - Country:US
Mailing Address - Phone:845-517-5252
Mailing Address - Fax:845-517-5253
Practice Address - Street 1:22 S MADISON AVE
Practice Address - Street 2:SUITE C
Practice Address - City:SPRING VALLEY
Practice Address - State:NY
Practice Address - Zip Code:10977-5525
Practice Address - Country:US
Practice Address - Phone:845-517-5252
Practice Address - Fax:845-517-5253
Is Sole Proprietor?:No
Enumeration Date:2007-11-06
Last Update Date:2009-12-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NYF34270-1363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY363LA2200XMedicare PIN