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General NPI Number Information
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NPI Number | 1861085334
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Entity Type | Individual
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Provider Name | MARLENE DAMIAN A-GACNP
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Gender | Female
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Dates
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Enumeration Date | 02/16/2021
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Last Update Date | 02/16/2021
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Provider Practice Location Address
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Address Line | 967 N BROADWAY
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City | YONKERS
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State | NY
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Zip | 10701-1301
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Country | US
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Telephone | 914-964-4444
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Fax |
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Provider Business Mailing Address
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Address Line | 506 N HIGH ST
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City | MOUNT VERNON
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State | NY
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Zip | 10552-3105
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Country | US
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Telephone | 914-513-1281
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 431938
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 431938
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 431938
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License Number State | NY
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Taxonomy #4
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 431938
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License Number State | NY
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