Provider Demographics
NPI:1689623936
Name:FIGUEROA, MARCIANO T (MD)
Entity Type:Individual
Prefix:
First Name:MARCIANO
Middle Name:T
Last Name:FIGUEROA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:759 HAMBURG TPKE
Mailing Address - Street 2:
Mailing Address - City:WAYNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07470-2017
Mailing Address - Country:US
Mailing Address - Phone:973-709-0099
Mailing Address - Fax:973-709-0201
Practice Address - Street 1:759 HAMBURG TPKE
Practice Address - Street 2:
Practice Address - City:WAYNE
Practice Address - State:NJ
Practice Address - Zip Code:07470-2017
Practice Address - Country:US
Practice Address - Phone:973-709-0099
Practice Address - Fax:973-709-0201
Is Sole Proprietor?:No
Enumeration Date:2006-05-06
Last Update Date:2014-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA 64799207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ896424WC0Medicare PIN