Provider Demographics
NPI:1992223994
Name:MARCIANO, FLORA ETTEL
Entity type:Individual
Prefix:
First Name:FLORA
Middle Name:ETTEL
Last Name:MARCIANO
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 1:134 WEST 26TH STREET
Mailing Address - Street 2:SUITE # 602
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10001
Mailing Address - Country:US
Mailing Address - Phone:212-604-9360
Mailing Address - Fax:212-604-9361
Practice Address - Street 1:134 WEST 26TH STREET
Practice Address - Street 2:SUITE # 602
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001
Practice Address - Country:US
Practice Address - Phone:212-604-9360
Practice Address - Fax:212-604-9361
Is Sole Proprietor?:No
Enumeration Date:2017-08-30
Last Update Date:2018-05-02
Deactivation Date:2018-04-06
Deactivation Code:
Reactivation Date:2018-05-02
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist