Provider Demographics
NPI:1689675019
Name:MARSCHEAN, MICHAEL SCOTT (CRNA)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:SCOTT
Last Name:MARSCHEAN
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 PARK ST
Mailing Address - Street 2:
Mailing Address - City:NORWOOD
Mailing Address - State:NY
Mailing Address - Zip Code:13668-1117
Mailing Address - Country:US
Mailing Address - Phone:315-262-6980
Mailing Address - Fax:
Practice Address - Street 1:26 PARK ST
Practice Address - Street 2:
Practice Address - City:NORWOOD
Practice Address - State:NY
Practice Address - Zip Code:13668-1117
Practice Address - Country:US
Practice Address - Phone:315-262-6980
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-09
Last Update Date:2016-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX652193367500000X
NY360311367500000X
NC259645367500000X
VA1242489367500000X
KY1135379367500000X
OK108520367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX145107201Medicaid
NYRB8149Medicare PIN
TX80628HMedicare ID - Type Unspecified
NYRB8149Medicare PIN