Provider Demographics
NPI:1629048921
Name:VARN, MARIANNE D (NP)
Entity Type:Individual
Prefix:MS
First Name:MARIANNE
Middle Name:D
Last Name:VARN
Suffix:
Gender:F
Credentials:NP
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Mailing Address - Street 1:1001 W FAYETTE ST
Mailing Address - Street 2:SUITE 400
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13204-2859
Mailing Address - Country:US
Mailing Address - Phone:315-472-1488
Mailing Address - Fax:315-472-8060
Practice Address - Street 1:16 BRENTWOOD DR STE B
Practice Address - Street 2:
Practice Address - City:ITHACA
Practice Address - State:NY
Practice Address - Zip Code:14850
Practice Address - Country:US
Practice Address - Phone:607-266-7500
Practice Address - Fax:607-257-4318
Is Sole Proprietor?:No
Enumeration Date:2006-01-26
Last Update Date:2018-08-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY330439363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYR54813Medicare UPIN
NYRB1155Medicare PIN