Provider Demographics
NPI:1053645903
Name:VERLASKY, MARC JOSEPH (NP)
Entity Type:Individual
Prefix:
First Name:MARC
Middle Name:JOSEPH
Last Name:VERLASKY
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3075 HEALTH CENTER DR STE 101
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92123-2773
Mailing Address - Country:US
Mailing Address - Phone:858-939-3831
Mailing Address - Fax:858-636-2901
Practice Address - Street 1:3075 HEALTH CENTER DR
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123-2773
Practice Address - Country:US
Practice Address - Phone:858-939-3831
Practice Address - Fax:858-636-2901
Is Sole Proprietor?:No
Enumeration Date:2009-09-24
Last Update Date:2019-02-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CANP674044363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner