| Doctor Name: | MARYELLEN SIEGEL |
| NPI Number: | 1548642671 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 351696 |
| Business Practice Address: | 1157 Route 55 Lagrangeville, NY - 125405021 |
| Business Phone Number: | 8454864860 |
| Business Fax Number: | |
| Mailing Address: | 41 Clover Hill Dr, POUGHKEEPSIE |
| State: | NY |
| Postal Code: | 126033201 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 06/25/2015 |
| NPI Last Update Date: | 06/25/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WS0200X |
| License Number: | 351696 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | School |
| Taxonomy Definition: | |