Basic Information
Provider Information
NPI: 1770187650
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MARKLAND
FirstName: TAKIYAHAYANA
MiddleName: CARIDAD
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 255 PATROON CREEK BLVD APT 1414
Address2:  
City: ALBANY
State: NY
PostalCode: 122065019
CountryCode: US
TelephoneNumber: 7185065688
FaxNumber:  
Practice Location
Address1: 1101 NOTT ST
Address2:  
City: SCHENECTADY
State: NY
PostalCode: 123082489
CountryCode: US
TelephoneNumber: 5182434000
FaxNumber:  
Other Information
ProviderEnumerationDate: 11/23/2020
LastUpdateDate: 11/23/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 11/23/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163W00000X751965NYY Nursing Service ProvidersRegistered Nurse 

No ID Information.


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