Basic Information
| Provider Information | |||||||||
| NPI: | 1841499860 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MARZANO XAVIER | ||||||||
| FirstName: | VIRGINIA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | B.A., M.S. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2330 REDMOND RD | ||||||||
| Address2: | |||||||||
| City: | NORTH BELLMORE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 117102152 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5167850884 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 189 WHEATLEY RD | ||||||||
| Address2: | |||||||||
| City: | GLEN HEAD | ||||||||
| State: | NY | ||||||||
| PostalCode: | 115452641 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5166261000 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/11/2007 | ||||||||
| LastUpdateDate: | 07/11/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 174400000X | 000198 | NY | Y | Other Service Providers | Specialist |
No ID Information.