Healthcare Provider Details

I. General information

NPI: 1427348051
Provider Name (Legal Business Name): RONALD VALER MARMASH MT-ASCP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/16/2011
Last Update Date: 04/16/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3113 BRITT ST NE
ALBUQUERQUE NM
87111-4954
US

IV. Provider business mailing address

3113 BRITT ST NE
ALBUQUERQUE NM
87111-4954
US

V. Phone/Fax

Practice location:
  • Phone: 505-280-3729
  • Fax:
Mailing address:
  • Phone: 505-280-3729
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246QM0706X
TaxonomyMedical Technologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: