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NPI Code Detail

MEDICARE: MARLEY ISIDORE

MEDICARE: MARLEY ISIDORE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1699644260
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARLEY ISIDORE
Provider Business Mailing Address
First Line : 965 TILTON RD
Second Line :
City : VALLEY COTTAGE
State : NY
Zip : 10989-2118
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 250 BEDFORD PARK BLVD W
Second Line :
City : BRONX
State : NY
Zip : 10468-1527
Country : US
Telephone Number : 718-960-5544
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/03/2025
Last Update Date : 11/03/2025

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Directions to “ MARLEY ISIDORE ” Practice Location

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