MEDICARE: MARC R SARNOW DPM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213E00000X	Podiatrist	N004680-1	NY

General Provider Information

NPI Number	:	1780759688
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MARC R SARNOW DPM

Provider Business Mailing Address
First Line	:	79 HAMMOND LN STE 9
Second Line	:
City	:	PLATTSBURGH
State	:	NY
Zip	:	12901-2008
Country	:	US
Telephone Number	:	518-563-0570
Fax Number	:	518-324-5406

Provider Business Practice Location Address
First Line	:	79 HAMMOND LN STE 9
Second Line	:
City	:	PLATTSBURGH
State	:	NY
Zip	:	12901-2008
Country	:	US
Telephone Number	:	518-563-0570
Fax Number	:	518-324-5406

Authorized Official
Title or Position	:	OWNER
Name	:	DR. MARC R SARNOW
Credential	:	DPM
Telephone Number	:	518-563-0570

Provider Enumeration Date	:	11/24/2006
Last Update Date	:	04/13/2023

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