Marylou E Jason, RN
Individual provider Active NPI Pediatric Registered Nurse · Durham, NY
NPI 1194154526 · NPPES record last updated Nov 6, 2013
Key facts
- NPI
- 1194154526
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatric Registered Nurse 163WP0200X
- License
- 401437 (NY)
- Practice address
- 4099 State Highway 145
Durham, NY 12422 - Phone
- (518) 259-8412
- Fax
- (518) 239-5925
- NPI assigned
- Nov 6, 2013
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 401437 | NY | MD | Pediatric Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Registered Nurse | 163WP0200X | 401437 | NY | Yes |
Addresses
Primary practice location
4099 State Highway 145
Durham, NY 12422
Mailing address
4099 State Highway 145
Durham, NY 12422
Phone (518) 259-8412
Other providers in Durham, NY
All providers in Durham, NY · Pediatric Registered Nurse in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 6, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.