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General NPI Number Information
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NPI Number | 1043611924
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Entity Type | Organization
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Legal Business Name | SHAIINA MARSTON
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Dates
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Enumeration Date | 09/10/2014
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Last Update Date | 09/10/2014
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Provider Practice Location Address
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Address Line | 206 WHALEY ST
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City | FREEPORT
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State | NY
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Zip | 11520-4223
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Country | US
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Telephone | 516-304-4714
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Fax |
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Provider Business Mailing Address
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Address Line | 206 WHALEY ST
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City | FREEPORT
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State | NY
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Zip | 11520-4223
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Country | US
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Telephone | 516-304-4714
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Fax |
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Authorized Official
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Title or Position | REGISTERED NURSE
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Name | MS. SHAIINA KHITANYA MARSTON
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Credential |
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Telephone | 516-304-4714
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 283Q00000X
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Taxonomy Name | Psychiatric Hospital
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License Number | 683949-1
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number | 683949-1
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License Number State | NY
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