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NPI Code Detail

MEDICARE: MARIAN THOMPSON N.P.

MEDICARE: MARIAN THOMPSON N.P.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LP0808XPsychiatric/Mental Health Nurse PractitionerF406690-01NY
2363LF0000XFamily Nurse PractitionerF340670-1NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1063863470
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARIAN THOMPSON N.P.
Provider Business Mailing Address
First Line : 930 S SALINA ST
Second Line :
City : SYRACUSE
State : NY
Zip : 13202-3530
Country : US
Telephone Number : 315-476-7921
Fax Number : 315-476-5529
Provider Business Practice Location Address
First Line : 930 S SALINA ST
Second Line :
City : SYRACUSE
State : NY
Zip : 13202-3530
Country : US
Telephone Number : 315-476-7921
Fax Number : 315-476-5529
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/27/2016
Last Update Date : 01/28/2025

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