Individual
MARILYN HUAMANTLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
503 S BROADWAY STE 210, YONKERS, NY 10705-6202
(914) 965-9783
Mailing address
503 S BROADWAY STE 210, YONKERS, NY 10705-6202
(914) 965-9783
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
322259
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/09/2020
Last updated
06/28/2023
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