Basic Information
| Provider Information | |||||||||
| NPI: | 1134482565 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | TITUS-PRESCOTT | ||||||||
| FirstName: | MARCIA | ||||||||
| MiddleName: | ANITA | ||||||||
| NamePrefix: | MRS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | RN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2017 SCHENECTADY AVE | ||||||||
| Address2: | |||||||||
| City: | BROOKLYN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 112343130 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7186776235 | ||||||||
| FaxNumber: | 7182368456 | ||||||||
| Practice Location | |||||||||
| Address1: | 40 RECTOR ST | ||||||||
| Address2: | |||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100061705 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2123853030 | ||||||||
| FaxNumber: | 2123852380 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/20/2012 | ||||||||
| LastUpdateDate: | 06/20/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WC1500X | 459265 | NY | N | Nursing Service Providers | Registered Nurse | Community Health | 163WP0808X | 459265 | NY | Y | Nursing Service Providers | Registered Nurse | Psych/Mental Health |
No ID Information.