MIKIKO DEMURA MARZILLI (NPI# 1205373578) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205373578 |
| Entity Type | Individual |
| Full Name | MIKIKO DEMURA MARZILLI |
| Credential | MS LD |
| Practice Address |
905 Union St Suite 11 Bangor ME 04401-3050 |
| Mailing Address |
43 Whiting Hill Rd Ste 300 Brewer ME 04412-1005 |
| Practice Telephone | 2079737364 |
| Mailing Telephone | 2079735035 |
| Mailing Fax Number | 2079735042 |
| Enumeration Date | 2017-01-25 |
| Last Update Date | 2017-01-25 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 133V00000X | Dietitian, Registered | TD1334 | ME | Dietary & Nutritional Service Providers |
| Street Address |
905 UNION ST SUITE 11 |
| City | BANGOR |
| State | ME |
| Zip Code | 04401-3050 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437197001 | Anthony Podraza | Clinical Neuropsychologist | 905 Union St, Suite 9, Bangor, ME 04401-3050 | 2006-06-03 |
| 1063969202 | Agnieszka Karolina Serwik Kronholm | Psychologist | 905 Union St, 9, Bangor, ME 04401-3050 | 2016-09-06 |
| 1952771594 | Danielle Katharine Morgan | Audiologist | 905 Union St, Suite 10, Bangor, ME 04401-3050 | 2015-09-25 |
| 1073935201 | Jeannine Marie Campbell | Audiologist | 905 Union St, Suite 10, Bangor, ME 04401-3050 | 2014-01-07 |
| 1922352152 | Valerie Nicole Curtis | Dietitian, Registered | 905 Union St, 11, Bangor, ME 04401-3050 | 2012-11-09 |
| 1639429624 | Nina E Boulard | Psychologist | 905 Union St, Ste 9, Bangor, ME 04401-3050 | 2012-09-17 |
| 1497904254 | Leanne Joy Carey | Registered Nurse | 905 Union St, Suite 11, Bangor, ME 04401-3050 | 2008-09-16 |
| 1083806525 | Alexius Enrique Garcia Sandoval | Physical Medicine & Rehabilitation | 905 Union St, Suite 9, Bangor, ME 04401-3050 | 2007-08-17 |
| 1740305697 | Linda A. Johnson | Registered Nurse | 905 Union St, Suite 11, Bangor, ME 04401-3050 | 2007-03-20 |
| 1063434827 | Louise Marie Pelletier | Registered Nurse | 905 Union St, Suite 11, Bangor, ME 04401-3050 | 2006-07-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184222523 | Bj's Wholesale Club Inc. | Eyewear Supplier (Equipment, not the service) | 110 Longview Dr, Bangor, ME 04401 | 2020-10-16 |
| 1033737937 | Daniel John Phulman | Counselor | 202 Exchange Street, Bangor, ME 04401 | 2020-07-08 |
| 1770104358 | Elizabeth Sarah Caruson | Physician Assistant | 417 State Street Webber Medical Building, East St, Ste. 121, Bangor, ME 04401 | 2020-05-05 |
| 1053961300 | Erika Dean | Occupational Therapist | 84 Sylvan Rd., Bangor, ME 04401 | 2019-09-18 |
| 1942853635 | Wildworks Therapy, Pllc | Occupational Therapist | 123 Mt Hope Ave, Bangor, ME 04401 | 2019-07-22 |
| 1255999173 | Jessica Arbisi | Physician Assistant | 1 Northeast Drive, Bangor, ME 04401 | 2019-06-05 |
| 1699232041 | Ehab Khamis Elhefnawi | Anesthesiology | Emmc Anesthesia Professional Service, 489 State Street, Bangor, ME 04401 | 2019-02-21 |
| 1477028884 | Zvorufura Makura | Otolaryngology | 885 Union Street, Ste 145, Bangor, ME 04401 | 2018-10-11 |
| 1255826541 | Lindsey M Fields | Optometrist | 955 Broadway Eye Center Northeast Dba Northeast Eyecare, Bangor, ME 04401 | 2018-06-28 |
| 1992211338 | Debra J Mcintyre | Counselor | 157 Park Street, #5, Bangor, ME 04401 | 2017-12-21 |
| Find all providers in zip 04401 | ||||
| Taxonomy Code | 133V00000X |
| Grouping | Dietary & Nutritional Service Providers |
| Classification | Dietitian, Registered |
| A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor’s degree at a US regionally accredited university or college and course work approved by The American Dietetic Association (ADA); an ADA-accredited or approved, supervised practice program, typically 6 to 12 months in length; a national examination administered by the Commission on Dietetic Registration; and continuing professional educational requirements to maintain registration. |
| Notes: Source: The American Dietetic Association. Becoming a Registered Dietitian – a food and nutrition expert. Chicago, IL: The American Dietetic Association, July 1997. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407476351 | Tara Gould | Dietitian, Registered | 6 State St Ste 607, Bangor, ME 04401-5140 | 2020-04-21 |
| 1487052536 | Andrea Marie Saquet | Dietitian, Registered | 905 Union Street, Suite 11, Bangor, ME 04401 | 2014-12-05 |
| 1578800397 | Kaileigh M Porter | Dietitian, Registered | 900 Broadway Bldg 3, Bangor, ME 04401 | 2013-01-14 |
| 1508149964 | Kateryna Vadimovna Clark | Dietitian, Registered | 135 Grove St, Bangor, ME 04401-4007 | 2011-09-22 |
| 1588813513 | Tama Catell Fitzpatrick | Dietitian, Registered | 905 Union St Ste 11, Bangor, ME 04401-3039 | 2008-09-15 |
| 1043830904 | Rd 207, LLC | Dietitian, Registered | 6 State St Ste 607, Bangor, ME 04401-5140 | 2020-04-21 |
| 1376089037 | Victoria Dorman | Dietitian, Registered | 133 Corporate Dr, Bangor, ME 04401-4312 | 2017-01-18 |
| 1679904130 | Ali M Caron | Dietitian, Registered | 489 State St, Bangor, ME 04401-6616 | 2013-12-10 |
| 1255678553 | Mellisa Bernardini | Dietitian, Registered | 992 Union St, Bangor, ME 04401-3057 | 2013-01-08 |
| 1922352152 | Valerie Nicole Curtis | Dietitian, Registered | 905 Union St, 11, Bangor, ME 04401-3050 | 2012-11-09 |
| Find all providers in BANGOR | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.