Individual
MISS MARILYN ARCHIBALD IV
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
REGISTERED NURSE
Contact information
Practice address
13 CLEVELAND ST, VALLEY STREAM, VALLEY STREAM, NY 11580-6003
(516) 823-0739
(516) 823-1550
Mailing address
1039 E 84TH ST, FLOOR 1, BROOKLYN, NY 11236-4227
(718) 304-4673
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
22 683025
NY
163WM0705X
Medical-Surgical Registered Nurse
Primary
22. 683025
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RN NO. 22 683025
REGISTERED NURSE
NY
Enumeration date
04/30/2014
Last updated
04/30/2014
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