Individual
MARCIA J NACKENSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
503 GRASSLANDS RD, STE. 200, VALHALLA, NY 10595-1503
(914) 304-5288
(914) 345-1755
Mailing address
503 GRASSLANDS RD, STE 200, VALHALLA, NY 10595-1503
(914) 304-5288
(914) 345-1755
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
156197
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01026246
—
NY
Enumeration date
07/20/2005
Last updated
07/23/2013
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