Individual
CRYSTAL BLUE-MARINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2075 3RD AVE, NEW YORK, NY 10029-2120
(917) 686-6989
Mailing address
2075 3RD AVE, NEW YORK, NY 10029-2120
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
921094
NY
164W00000X
Licensed Practical Nurse
336535
NY
Other
Enumeration date
09/30/2020
Last updated
05/23/2024
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