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General NPI Number Information
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NPI Number | 1730145855
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Entity Type | Individual
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Provider Name | JOSEPH M MARRA MD
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Gender | Male
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Dates
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Enumeration Date | 04/26/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 621 10TH ST
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City | NIAGARA FALLS
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State | NY
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Zip | 14301-1813
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Country | US
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Telephone | 716-692-3302
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 8000 DEPT. 194
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City | BUFFALO
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State | NY
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Zip | 14267-0002
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Country | US
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Telephone | 716-692-3302
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Fax | 716-692-4342
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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 | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number | 193607
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License Number State | NY
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