Provider Demographics
NPI:1073328829
Name:GAUTHRIN, MARION
Entity type:Individual
Prefix:MISS
First Name:MARION
Middle Name:
Last Name:GAUTHRIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 JOURNAL SQ STE 426
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07306-4007
Mailing Address - Country:US
Mailing Address - Phone:551-205-0301
Mailing Address - Fax:
Practice Address - Street 1:35 JOURNAL SQ STE 426
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07306-4007
Practice Address - Country:US
Practice Address - Phone:551-205-0301
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-10
Last Update Date:2025-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion