Individual
JADICA ALEXIS MARRERO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PARAPROFESSIONAL
Contact information
Practice address
100 EINSTEIN LOOP APT 23G, BRONX, NY 10475-4948
(929) 233-4490
Mailing address
100 EINSTEIN LOOP APT 23G, BRONX, NY 10475-4948
(929) 233-4490
Taxonomy
Speciality
Code
Description
License number
State
246RP1900X
Phlebotomy Technician
Primary
—
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
984670396
IDENTIFICATION CARD
NY
01
—
JUN90010T01
EMBLEM HIP
NY
Enumeration date
10/18/2016
Last updated
10/18/2016
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