Individual
MARIELLE TAGANAJAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
440 W 114TH ST STE 220, NEW YORK, NY 10025-1796
(212) 523-9215
Mailing address
14017 84TH DR APT 7H, BRIARWOOD, NY 11435-2423
(917) 428-8096
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
F308118-1
NY
Other
Enumeration date
09/17/2018
Last updated
04/14/2021
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