Healthcare Provider Details

I. General information

NPI: 1821363029
Provider Name (Legal Business Name): THOMAS URBAN MARRON M.D. PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2012
Last Update Date: 02/26/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 E 102ND ST
NEW YORK NY
10029-6030
US

IV. Provider business mailing address

1 GUSTAVE L LEVY PL # 3000
NEW YORK NY
10029-6504
US

V. Phone/Fax

Practice location:
  • Phone: 212-241-6756
  • Fax: 212-423-0522
Mailing address:
  • Phone: 212-987-3100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number272727
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: