Healthcare Provider Details

I. General information

NPI: 1568634814
Provider Name (Legal Business Name): MARCUS S NOEL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2008
Last Update Date: 07/01/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 ELMWOOD AVE
ROCHESTER NY
14642-0001
US

IV. Provider business mailing address

1000 SOUTH AVE BOX 58
ROCHESTER NY
14620-2733
US

V. Phone/Fax

Practice location:
  • Phone: 585-275-5863
  • Fax: 585-273-5761
Mailing address:
  • Phone: 585-275-5863
  • Fax: 585-273-5761

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number257169
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number257169
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number257169
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: