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General NPI Number Information
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NPI Number | 1841703386
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Entity Type | Individual
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Provider Name | JOSEPH MARSHALL MS ED
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Gender | Male
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Dates
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Enumeration Date | 11/07/2017
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 4242 RIDGE LEA RD STE 2
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City | AMHERST
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State | NY
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Zip | 14226-5122
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Country | US
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Telephone | 716-819-2400
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Fax |
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Provider Business Mailing Address
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Address Line | 6281 BROADWAY ST
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City | LANCASTER
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State | NY
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Zip | 14086-9517
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Country | US
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Telephone | 716-462-9805
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | 890016141
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License Number State | NY
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