Individual
MRS. COLLETTE MARSHALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8 CHARLES ST, VALLEY STREAM, NY 11580-2217
(718) 419-9136
Mailing address
8 CHARLES ST, VALLEY STREAM, NY 11580-2217
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
592911
NY
363LF0000X
Family Nurse Practitioner
346065
NY
Other
Enumeration date
12/26/2008
Last updated
11/05/2020
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