Provider Demographics
NPI:1992055875
Name:SCIBERRAS, MARIANNE J
Entity type:Individual
Prefix:MS
First Name:MARIANNE
Middle Name:J
Last Name:SCIBERRAS
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 1:2460 24TH ST
Mailing Address - Street 2:
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11102-2828
Mailing Address - Country:US
Mailing Address - Phone:718-606-9996
Mailing Address - Fax:
Practice Address - Street 1:2460 24TH ST
Practice Address - Street 2:
Practice Address - City:ASTORIA
Practice Address - State:NY
Practice Address - Zip Code:11102-2828
Practice Address - Country:US
Practice Address - Phone:718-606-9996
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-18
Last Update Date:2012-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered