Provider Demographics
NPI:1285734053
Name:ALBARILLO, MARIE VEE S (PA)
Entity type:Individual
Prefix:MS
First Name:MARIE VEE
Middle Name:S
Last Name:ALBARILLO
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:419 E 81ST ST
Mailing Address - Street 2:APT 1C
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10028-5113
Mailing Address - Country:US
Mailing Address - Phone:646-684-3388
Mailing Address - Fax:
Practice Address - Street 1:16 GUION PL
Practice Address - Street 2:
Practice Address - City:NEW ROCHELLE
Practice Address - State:NY
Practice Address - Zip Code:10801-5503
Practice Address - Country:US
Practice Address - Phone:914-637-1471
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009681363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00246075Medicaid
NYQ47774Medicare UPIN
NY00330231Medicare ID - Type Unspecified