Provider Demographics
NPI:1912876632
Name:ANTOINE, MARCDANA
Entity type:Individual
Prefix:
First Name:MARCDANA
Middle Name:
Last Name:ANTOINE
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 1:70 YAREMICH DR APT 5
Mailing Address - Street 2:
Mailing Address - City:BRIDGEPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06606-2584
Mailing Address - Country:US
Mailing Address - Phone:475-369-4908
Mailing Address - Fax:
Practice Address - Street 1:70 YAREMICH DR APT 5
Practice Address - Street 2:
Practice Address - City:BRIDGEPORT
Practice Address - State:CT
Practice Address - Zip Code:06606-2584
Practice Address - Country:US
Practice Address - Phone:475-369-4908
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-31
Last Update Date:2025-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician