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General NPI Number Information
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NPI Number | 1568667210
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Entity Type | Individual
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Provider Name | ANTONIO V.R. MAROTTA D.C.
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Gender | Male
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Dates
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Enumeration Date | 06/20/2007
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Last Update Date | 04/24/2013
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Provider Practice Location Address
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Address Line | 939 ROUTE 146 SUITE 230
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City | CLIFTON PARK
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State | NY
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Zip | 12065-3662
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Country | US
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Telephone | 518-357-3347
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Fax |
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Provider Business Mailing Address
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Address Line | 939 ROUTE 146 230
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City | CLIFTON PARK
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State | NY
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Zip | 12065-3662
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Country | US
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Telephone | 518-357-3347
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Fax |
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | X011500
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License Number State | NY
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