Provider Demographics
NPI:1609190560
Name:WORCZAK, MARIANNA (MD)
Entity Type:Individual
Prefix:
First Name:MARIANNA
Middle Name:
Last Name:WORCZAK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:535 MAIN ST
Mailing Address - Street 2:STE 1
Mailing Address - City:OLEAN
Mailing Address - State:NY
Mailing Address - Zip Code:14760-1500
Mailing Address - Country:US
Mailing Address - Phone:802-881-5827
Mailing Address - Fax:
Practice Address - Street 1:535 MAIN ST
Practice Address - Street 2:STE 1
Practice Address - City:OLEAN
Practice Address - State:NY
Practice Address - Zip Code:14760-1500
Practice Address - Country:US
Practice Address - Phone:716-372-0141
Practice Address - Fax:716-372-6421
Is Sole Proprietor?:No
Enumeration Date:2010-03-22
Last Update Date:2014-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY270703207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine