Provider Demographics
NPI:1467464131
Name:MAROLDO, ANTHONY MICHAEL (MD)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:MICHAEL
Last Name:MAROLDO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 278984
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14627-8984
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:919 WESTFALL RD
Practice Address - Street 2:BLDG C-STE 220
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14618-2638
Practice Address - Country:US
Practice Address - Phone:585-341-7500
Practice Address - Fax:585-756-2311
Is Sole Proprietor?:No
Enumeration Date:2006-08-12
Last Update Date:2023-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2421242084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYRB4764OtherMEDICARE PTAN