MEDICARE: MICHELLE MARION

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
1	104100000X	Social Worker	44SL07040000	NJ
2	104100000X	Social Worker	44SL07040000	NY

General Provider Information

NPI Number	:	1528840246
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHELLE MARION

Provider Business Mailing Address
First Line	:	20 W 34TH ST
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10118-0114
Country	:	US
Telephone Number	:	--
Fax Number	:

Provider Business Practice Location Address
First Line	:	20 W 34TH ST
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10118-0114
Country	:	US
Telephone Number	:	--
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/17/2023
Last Update Date	:	07/25/2024

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Directions to “ MICHELLE MARION ” Practice Location

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