Provider Demographics
NPI:1457450850
Name:ZAREMBA, MARK ANTHONY (OD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:ANTHONY
Last Name:ZAREMBA
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1650 POPLAR LN
Mailing Address - Street 2:
Mailing Address - City:PAINESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44077-6126
Mailing Address - Country:US
Mailing Address - Phone:440-350-9491
Mailing Address - Fax:
Practice Address - Street 1:77 NORMANDY DR
Practice Address - Street 2:
Practice Address - City:PAINESVILLE
Practice Address - State:OH
Practice Address - Zip Code:44077-1615
Practice Address - Country:US
Practice Address - Phone:440-352-0616
Practice Address - Fax:440-352-0618
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5424152WC0802X, 152WL0500X, 152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
No152WL0500XEye and Vision Services ProvidersOptometristLow Vision Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2429858Medicaid
OHU96933Medicare UPIN
OHP00093928Medicare PIN
OH4117193Medicare PIN
OH2429858Medicaid