Provider Demographics
NPI:1235589300
Name:MARCY, ANDREW CYRUS (NP)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:CYRUS
Last Name:MARCY
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 SCHOEN PL STE 5
Mailing Address - Street 2:
Mailing Address - City:PITTSFORD
Mailing Address - State:NY
Mailing Address - Zip Code:14534-2055
Mailing Address - Country:US
Mailing Address - Phone:585-563-9989
Mailing Address - Fax:585-532-7824
Practice Address - Street 1:11 SCHOEN PL STE 5
Practice Address - Street 2:
Practice Address - City:PITTSFORD
Practice Address - State:NY
Practice Address - Zip Code:14534-2055
Practice Address - Country:US
Practice Address - Phone:585-563-9989
Practice Address - Fax:585-532-7824
Is Sole Proprietor?:No
Enumeration Date:2016-06-20
Last Update Date:2023-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF402008363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYJ400374766-GRP70008AMedicare PIN
NYJ400374776Medicare PIN
NYJ400374778-GRPBA0017Medicare PIN