Individual provider · Type 1 NPI
Marley Jane Fanning
Physician Assistant · New York, NY
Practice location
1901 1st Ave Ste 12A19
New York, NY 10029-7494
Mailing address
1112 Edgewater Club Rd
Wilmington, NC 28411-9355
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Physician Assistant Primary | 363A00000X | 034650 (NY) |
Physician Assistant: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, orde…
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About NPI 1093685059
Marley Jane Fanning's National Provider Identifier is 1093685059, issued on Nov 6, 2025. The primary taxonomy on file is Physician Assistant (363A00000X), and the practice location is in New York, NY. The record was last updated on Nov 6, 2025.