Healthcare Provider Details

I. General information

NPI: 1396609434
Provider Name (Legal Business Name): DEBORAH GAE UMAYAM MARALIT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/12/2025
Last Update Date: 12/12/2025
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3127 WILKINSON AVE
BRONX NY
10461-4607
US

IV. Provider business mailing address

2775 MORGAN AVE
BRONX NY
10469-5520
US

V. Phone/Fax

Practice location:
  • Phone: 718-993-3458
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License Number758788
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: