Provider Demographics
NPI:1336545573
Name:MARQUES, MYRIAM
Entity type:Individual
Prefix:MS
First Name:MYRIAM
Middle Name:
Last Name:MARQUES
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:MYRIAM
Other - Middle Name:SILVA
Other - Last Name:MARQUES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:18 MICIELI PL # 2F
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11218-2108
Mailing Address - Country:US
Mailing Address - Phone:215-730-1593
Mailing Address - Fax:
Practice Address - Street 1:18 MICIELI PL # 2F
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11218-2108
Practice Address - Country:US
Practice Address - Phone:215-730-1593
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-17
Last Update Date:2014-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY531822-1163W00000X, 163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WC1500XNursing Service ProvidersRegistered NurseCommunity Health