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General NPI Number Information
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NPI Number | 1992783864
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Entity Type | Organization
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Legal Business Name | SERGIO MARANO O.D. MARK GRISAR O.D. PC
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Dates
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Enumeration Date | 01/02/2006
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Last Update Date | 10/11/2013
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Provider Practice Location Address
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Address Line | 1765 CENTRAL PARK AVE
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City | YONKERS
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State | NY
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Zip | 10710-2828
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Country | US
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Telephone | 914-961-1004
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Fax | 914-961-7636
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Provider Business Mailing Address
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Address Line | 1765 CENTRAL PARK AVE
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City | YONKERS
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State | NY
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Zip | 10710-2828
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Country | US
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Telephone | 914-961-1004
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Fax | 914-961-7636
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SERGIO MARANO
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Credential | O.D.
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Telephone | 914-961-1004
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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