Healthcare Provider Details

I. General information

NPI: 1598885824
Provider Name (Legal Business Name): GARY F. MARRONE, O.D., P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/30/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3649 ERIE BLVD E
SYRACUSE NY
13214-2738
US

IV. Provider business mailing address

3649 ERIE BLVD E
SYRACUSE NY
13214-2738
US

V. Phone/Fax

Practice location:
  • Phone: 315-446-1288
  • Fax: 314-446-1860
Mailing address:
  • Phone: 315-446-1288
  • Fax: 314-446-1860

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152WC0802X
TaxonomyCorneal and Contact Management Optometrist
License NumberTUVOO4159-1
License Number StateNY

VIII. Authorized Official

Name: GARY FRANCIS MARRONE
Title or Position: OPTOMETRIST
Credential: O.D.
Phone: 314-446-1288