Provider Demographics
NPI:1003889700
Name:MARFATIA MEDICAL PLLC
Entity Type:Organization
Organization Name:MARFATIA MEDICAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:RASHNA
Authorized Official - Middle Name:A
Authorized Official - Last Name:COOPER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:585-786-2769
Mailing Address - Street 1:214 WYOMING ST
Mailing Address - Street 2:
Mailing Address - City:WARSAW
Mailing Address - State:NY
Mailing Address - Zip Code:14569-9523
Mailing Address - Country:US
Mailing Address - Phone:585-786-2769
Mailing Address - Fax:585-786-0508
Practice Address - Street 1:5596 ROUTE 19A
Practice Address - Street 2:
Practice Address - City:CASTILE
Practice Address - State:NY
Practice Address - Zip Code:14427-9757
Practice Address - Country:US
Practice Address - Phone:585-493-9230
Practice Address - Fax:585-786-0508
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-12
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY224172207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY000525403002OtherBCBS WNY
NY0410493OtherINDEPENDENT HEALTH
NY2710199OtherAETNA
NY224172-7BOtherWORKERS COMPENSATION
NY106101BJOtherPREFERRED CARE
NY7774326OtherAETNA
NY00010372202OtherUNIVERA
NY000525403003OtherBCBS WNY
NY2514266OtherGHI
NY01916687Medicaid
NY2514266OtherGHI
NY01916687Medicaid
NY0410493OtherINDEPENDENT HEALTH
NY224172-7BOtherWORKERS COMPENSATION
NY106101BJOtherPREFERRED CARE