Provider Demographics
NPI:1437108560
Name:HUBBARD, MARILYN DAVEY (NP)
Entity type:Individual
Prefix:MS
First Name:MARILYN
Middle Name:DAVEY
Last Name:HUBBARD
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2406 SUNSET AVE
Mailing Address - Street 2:
Mailing Address - City:UTICA
Mailing Address - State:NY
Mailing Address - Zip Code:13502-5746
Mailing Address - Country:US
Mailing Address - Phone:315-797-5841
Mailing Address - Fax:
Practice Address - Street 1:502 COURT ST
Practice Address - Street 2:
Practice Address - City:UTICA
Practice Address - State:NY
Practice Address - Zip Code:13502-4233
Practice Address - Country:US
Practice Address - Phone:315-792-7626
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-08
Last Update Date:2025-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF303936363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner