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General NPI Number Information
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NPI Number | 1295080117
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Entity Type | Individual
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Provider Name | MARSHALL WINKLER MS,ED.
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Gender | Male
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Dates
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Enumeration Date | 07/17/2012
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Last Update Date | 11/09/2021
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Provider Practice Location Address
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Address Line | 3 CEDAR PL
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City | MASSAPEQUA PARK
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State | NY
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Zip | 11762-1401
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Country | US
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Telephone | 917-604-6802
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Fax |
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Provider Business Mailing Address
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Address Line | 29 HOLLY HILL LN
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City | CORAM
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State | NY
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Zip | 11727-1825
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171W00000X
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Taxonomy Name | Contractor
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License Number |
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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