Provider Demographics
NPI:1154944817
Name:MAREK, ANGELA (CNA)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:MAREK
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:249 SHREWSBURY ST APT 1
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01604-4073
Mailing Address - Country:US
Mailing Address - Phone:774-303-6797
Mailing Address - Fax:
Practice Address - Street 1:249 SHREWSBURY ST APT 1
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01604-4073
Practice Address - Country:US
Practice Address - Phone:774-303-6797
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-28
Last Update Date:2020-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MACNA-129257376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide