Healthcare Provider Details

I. General information

NPI: 1689623936
Provider Name (Legal Business Name): MARCIANO T. FIGUEROA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/06/2006
Last Update Date: 06/05/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

759 HAMBURG TPKE
WAYNE NJ
07470-2017
US

IV. Provider business mailing address

759 HAMBURG TPKE
WAYNE NJ
07470-2017
US

V. Phone/Fax

Practice location:
  • Phone: 973-709-0099
  • Fax: 973-709-0201
Mailing address:
  • Phone: 973-709-0099
  • Fax: 973-709-0201

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QG0300X
TaxonomyGeriatric Medicine (Family Medicine) Physician
License NumberMA 64799
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: