Provider Demographics
NPI:1104064658
Name:ZEENA L. MARSHALL PHYSICIAN PC
Entity type:Organization
Organization Name:ZEENA L. MARSHALL PHYSICIAN PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ZEENA
Authorized Official - Middle Name:LATIF
Authorized Official - Last Name:MARSHALL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:914-337-3253
Mailing Address - Street 1:130 PONDFIELD RD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:BRONXVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:10708-4015
Mailing Address - Country:US
Mailing Address - Phone:914-337-3253
Mailing Address - Fax:914-771-5278
Practice Address - Street 1:130 PONDFIELD RD
Practice Address - Street 2:SUITE 2
Practice Address - City:BRONXVILLE
Practice Address - State:NY
Practice Address - Zip Code:10708-4015
Practice Address - Country:US
Practice Address - Phone:914-337-3253
Practice Address - Fax:914-771-5278
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-21
Last Update Date:2009-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1873752084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Single Specialty