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General NPI Number Information
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NPI Number | 1629693437
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Entity Type | Organization
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Legal Business Name | MARA HEALTH SOLUTIONS LLC
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Dates
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Enumeration Date | 06/08/2020
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Last Update Date | 06/08/2020
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Provider Practice Location Address
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Address Line | 323 WINTHROP ST
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City | BROOKLYN
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State | NY
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Zip | 11225-3813
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Country | US
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Telephone | 917-767-0309
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Fax |
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Provider Business Mailing Address
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Address Line | 323 WINTHROP ST
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City | BROOKLYN
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State | NY
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Zip | 11225-3813
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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 | NURSE PRACTITIONER
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Name | SHAMARA ALTERNO
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Credential | NP
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Telephone | 917-767-0309
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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