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General NPI Number Information
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NPI Number | 1578474888
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Entity Type | Individual
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Provider Name | MARILIN SAGASTUME FENELUS
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Gender |
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Dates
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Enumeration Date | 09/15/2026
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Last Update Date | 09/15/2026
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Provider Practice Location Address
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Address Line | 42 N MAIN ST
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City | SPRING VALLEY
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State | NY
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Zip | 10977-4906
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Country | US
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Telephone | 845-327-7493
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Fax |
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Provider Business Mailing Address
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Address Line | 42 N MAIN ST
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City | SPRING VALLEY
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State | NY
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Zip | 10977-4906
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | N56908
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License Number State | NY
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