Marilyn Halladay

Individual provider Active NPI Licensed Practical Nurse · Sherburne, NY

NPI 1457587263 · NPPES record last updated Jun 8, 2009

Key facts

NPI
1457587263
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
283966-1 (NY)
Practice address
94 North Main Street
Sherburne, NY 13460
Phone
(607) 674-6465
NPI assigned
Jun 8, 2009
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

State licenses

LicenseStateTypeSpecialty
283966-1NYMDLicensed Practical Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 283966-1 NY Yes

Addresses

Primary practice location

94 North Main Street
Sherburne, NY 13460

Mailing address

94 North Main Street
Sherburne, NY 13460

Other providers in Sherburne, NY

All providers in Sherburne, NY · Licensed Practical Nurse in New York

Sources for this page

Verify at the official NPI Registry.