Provider Demographics
NPI:1306115415
Name:SABUDA, MARLA DIANE (RN)
Entity type:Individual
Prefix:
First Name:MARLA
Middle Name:DIANE
Last Name:SABUDA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:811 NEW YORK AVE
Mailing Address - Street 2:APT 1006
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11203-2720
Mailing Address - Country:US
Mailing Address - Phone:716-517-5052
Mailing Address - Fax:
Practice Address - Street 1:500 W 57TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-2902
Practice Address - Country:US
Practice Address - Phone:212-293-3000
Practice Address - Fax:212-293-3020
Is Sole Proprietor?:No
Enumeration Date:2011-12-19
Last Update Date:2011-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY650965163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse