Provider Demographics
NPI:1265479851
Name:MARATHON MEDICAL, P.C.
Entity Type:Organization
Organization Name:MARATHON MEDICAL, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:VAN
Authorized Official - Middle Name:HONG
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-426-7300
Mailing Address - Street 1:35 EAST 85TH STREET
Mailing Address - Street 2:SUITE 1 & 2
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10028
Mailing Address - Country:US
Mailing Address - Phone:212-426-7300
Mailing Address - Fax:212-426-8385
Practice Address - Street 1:35 EAST 85TH STREET
Practice Address - Street 2:SUITE 1 & 2
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10028
Practice Address - Country:US
Practice Address - Phone:212-426-7300
Practice Address - Fax:212-426-8385
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-01
Last Update Date:2012-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207UN0901XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear CardiologyGroup - Multi-Specialty
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYWGW231Medicare UPIN
NYA63571Medicare UPIN
NYB17022Medicare UPIN
NYH71852Medicare UPIN
NYG45894Medicare UPIN