Provider Demographics
NPI:1437680774
Name:ERNEST R MARRONE DC DABCO
Entity Type:Organization
Organization Name:ERNEST R MARRONE DC DABCO
Other - Org Name:ERNEST R MARRONE SR D.C.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SOLE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:ERNEST
Authorized Official - Middle Name:R
Authorized Official - Last Name:MARRONE
Authorized Official - Suffix:SR
Authorized Official - Credentials:DC
Authorized Official - Phone:203-667-4445
Mailing Address - Street 1:70 DEARFIELD DR
Mailing Address - Street 2:
Mailing Address - City:GREENWICH
Mailing Address - State:CT
Mailing Address - Zip Code:06831
Mailing Address - Country:US
Mailing Address - Phone:203-661-4445
Mailing Address - Fax:203-661-4445
Practice Address - Street 1:70 DEARFIELD DR
Practice Address - Street 2:
Practice Address - City:GREENWICH
Practice Address - State:CT
Practice Address - Zip Code:06831
Practice Address - Country:US
Practice Address - Phone:203-661-4445
Practice Address - Fax:203-661-4445
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ERNEST R MARRONE DC DABCO
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-03-27
Last Update Date:2017-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT85111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT350000810Medicare UPIN