Provider Demographics
NPI:1487807582
Name:MARSCHALL, TANIA URSZULA
Entity type:Individual
Prefix:MS
First Name:TANIA
Middle Name:URSZULA
Last Name:MARSCHALL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7754 DEERFIELD RD
Mailing Address - Street 2:
Mailing Address - City:LIVERPOOL
Mailing Address - State:NY
Mailing Address - Zip Code:13090-2308
Mailing Address - Country:US
Mailing Address - Phone:315-409-3791
Mailing Address - Fax:
Practice Address - Street 1:7754 DEERFIELD RD
Practice Address - Street 2:
Practice Address - City:LIVERPOOL
Practice Address - State:NY
Practice Address - Zip Code:13090-2308
Practice Address - Country:US
Practice Address - Phone:315-409-3791
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-03
Last Update Date:2016-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF402032-1363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health