Healthcare Provider Details

I. General information

NPI: 1497061501
Provider Name (Legal Business Name): JOHN MARRO PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/26/2010
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

407 WOODSTOCK AVE
STATEN ISLAND NY
10301-3037
US

IV. Provider business mailing address

407 WOODSTOCK AVE
STATEN ISLAND NY
10301-3037
US

V. Phone/Fax

Practice location:
  • Phone: 917-426-2156
  • Fax: 917-590-4864
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number052088
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: