Provider Demographics
NPI:1114339710
Name:MARNE OSHAE MD PLLC
Entity Type:Organization
Organization Name:MARNE OSHAE MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARNE
Authorized Official - Middle Name:
Authorized Official - Last Name:OSHAE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:607-273-5551
Mailing Address - Street 1:402 N CAYUGA ST
Mailing Address - Street 2:
Mailing Address - City:ITHACA
Mailing Address - State:NY
Mailing Address - Zip Code:14850-4291
Mailing Address - Country:US
Mailing Address - Phone:607-273-5551
Mailing Address - Fax:607-275-0313
Practice Address - Street 1:402 N CAYUGA ST
Practice Address - Street 2:
Practice Address - City:ITHACA
Practice Address - State:NY
Practice Address - Zip Code:14850-4291
Practice Address - Country:US
Practice Address - Phone:607-273-5551
Practice Address - Fax:607-275-0313
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-30
Last Update Date:2014-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY228335-1207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty