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General NPI Number Information
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NPI Number | 1750791612
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Entity Type | Individual
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Provider Name | MARILYN DONETTE BLACKMAN REGISTERED NURSE
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Gender | Female
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Dates
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Enumeration Date | 04/30/2014
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Last Update Date | 08/04/2026
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Provider Practice Location Address
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Address Line | 1 CROSS ISLAND PLZ STE 210
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City | ROSEDALE
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State | NY
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Zip | 11422-1456
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Country | US
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Telephone | 718-978-4999
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Fax |
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Provider Business Mailing Address
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Address Line | 537 POWELL ST PH
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City | BROOKLYN
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State | NY
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Zip | 11212-7110
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Country | US
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Telephone | 718-304-4673
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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 | 22 683025
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 163WM0705X
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Taxonomy Name | Medical-Surgical Registered Nurse
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License Number | 22. 683025
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License Number State | NY
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