=====================================================
General NPI Number Information
=====================================================
NPI Number | 1134041569
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | EMILIENNE MARCELIN
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/28/2026
-----------------------------------------------------
Last Update Date | 07/28/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | NORTHEAST HEALTH SERVICES LLC 8 NORTH MAIN STREETBRONSON BUILDING, 5TH FLOOR
-----------------------------------------------------
City | ATTLEBORO
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 02703
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 508-794-8711
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 198 BROOK ST
-----------------------------------------------------
City | REHOBOTH
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 02769-1741
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 774-467-7951
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 163WG0000X
-----------------------------------------------------
Taxonomy Name | General Practice Registered Nurse
-----------------------------------------------------
License Number | RN2359332
-----------------------------------------------------
License Number State | MA
-----------------------------------------------------