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General NPI Number Information
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NPI Number | 1881908770
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Entity Type | Organization
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Legal Business Name | MARC SAFRAN, MD PLLC
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Dates
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Enumeration Date | 08/03/2010
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Last Update Date | 12/18/2012
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Provider Practice Location Address
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Address Line | 8340 OSWEGO RD
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City | LIVERPOOL
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State | NY
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Zip | 13090-1026
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Country | US
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Telephone | 315-622-1234
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Fax | 315-622-0018
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Provider Business Mailing Address
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Address Line | 8340 OSWEGO RD
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City | LIVERPOOL
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State | NY
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Zip | 13090-1026
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Country | US
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Telephone | 315-622-1234
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Fax | 315-622-0018
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Authorized Official
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Title or Position | OWNER
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Name | DR. MARC J SAFRAN
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Credential | M.D.
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Telephone | 315-622-1234
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number | 200315
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License Number State | NY
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