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NPI Code Detail

MEDICARE: DR. BRENDA MARSHALL EDD, N.P.

MEDICARE: DR. BRENDA MARSHALL EDD, N.P.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163WP0809XAdult Psychiatric/Mental Health Registered Nurse26NJ00207700NJ

General Provider Information

NPI Number : 1275868762
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. BRENDA MARSHALL EDD, N.P.
Provider Business Mailing Address
First Line : 305 TERHUNE DR
Second Line :
City : WAYNE
State : NJ
Zip : 07470-7105
Country : US
Telephone Number : 973-616-5362
Fax Number :
Provider Business Practice Location Address
First Line : 525 WANAQUE AVE
Second Line : SUITE 203
City : POMPTON LAKES
State : NJ
Zip : 07442-1843
Country : US
Telephone Number : 973-685-7000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/16/2009
Last Update Date : 10/16/2009

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