Provider Demographics
NPI:1609410406
Name:POW, MARVA J (RN)
Entity type:Individual
Prefix:MS
First Name:MARVA
Middle Name:J
Last Name:POW
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 GRAMATAN AVE STE 506
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:NY
Mailing Address - Zip Code:10550-3208
Mailing Address - Country:US
Mailing Address - Phone:914-733-5995
Mailing Address - Fax:
Practice Address - Street 1:3644 HARPER AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10466-5907
Practice Address - Country:US
Practice Address - Phone:914-733-5995
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-05
Last Update Date:2022-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY593629-1163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY593629-1OtherREGISTERED NURSE