Individual
MARZIA TINWALA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
416 PARK AVE, MERRICK, NY 11566-2248
(917) 517-9849
Mailing address
416 PARK AVE, MERRICK, NY 11566-2248
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
316449356
DRIVER LICENSE
NY
Enumeration date
08/19/2020
Last updated
08/19/2020
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