Provider Demographics
NPI:1598885824
Name:GARY F. MARRONE, O.D., P.C.
Entity Type:Organization
Organization Name:GARY F. MARRONE, O.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:
Authorized Official - First Name:GARY
Authorized Official - Middle Name:FRANCIS
Authorized Official - Last Name:MARRONE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:314-446-1288
Mailing Address - Street 1:3649 ERIE BLVD E
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13214-2738
Mailing Address - Country:US
Mailing Address - Phone:315-446-1288
Mailing Address - Fax:314-446-1860
Practice Address - Street 1:3649 ERIE BLVD E
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13214-2738
Practice Address - Country:US
Practice Address - Phone:315-446-1288
Practice Address - Fax:314-446-1860
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUVOO4159-1152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact ManagementGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY52589AMedicare ID - Type Unspecified