Healthcare Provider Details

I. General information

NPI: 1972569309
Provider Name (Legal Business Name): MICHAEL ARTHUR MARANO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/25/2006
Last Update Date: 07/16/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

94 OLD SHORT HILLS ROAD
LIVINGSTON NJ
07039-5672
US

IV. Provider business mailing address

94 OLD SHORT HILLS ROAD
LIVINGSTON NJ
07039-5672
US

V. Phone/Fax

Practice location:
  • Phone: 973-322-5924
  • Fax: 973-322-5447
Mailing address:
  • Phone: 973-322-5924
  • Fax: 973-322-5447

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberMA58983
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code2086S0102X
TaxonomySurgical Critical Care Physician
License NumberMA58983
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: