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General NPI Number Information
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NPI Number | 1437116191
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Entity Type | Individual
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Provider Name | MARC ALAN SIROTA MD
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Gender | Male
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Dates
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Enumeration Date | 04/27/2006
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Last Update Date | 11/19/2010
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Provider Practice Location Address
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Address Line | 3127 41ST ST
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City | ASTORIA
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State | NY
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Zip | 11103-3901
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Country | US
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Telephone | 718-728-3400
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Fax | 718-721-7562
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Provider Business Mailing Address
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Address Line | 114 E 13TH ST APT. 8B
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City | NEW YORK
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State | NY
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Zip | 10003-5329
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Country | US
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Telephone | 718-728-3400
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Fax | 718-721-7562
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 146643
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License Number State | NY
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