| Doctor Name: | MARCIA RUTHERFORD |
| NPI Number: | 1164896478 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | FNP |
| License Number: | F338860 |
| Business Practice Address: | 14445 87th Ave Briarwood, NY - 114353109 |
| Business Phone Number: | 7184804016 |
| Business Fax Number: | 7189069964 |
| Mailing Address: | 11655 147th St, JAMAICA |
| State: | NY |
| Postal Code: | 114361310 |
| Phone Number: | 3473924624 |
| Fax Number: | |
| NPI Enumeration Date: | 11/24/2015 |
| NPI Last Update Date: | 12/01/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | F338860 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |