Provider Demographics
NPI:1851351902
Name:ARRASCUE, MARCO ANTONIO (MD)
Entity Type:Individual
Prefix:DR
First Name:MARCO
Middle Name:ANTONIO
Last Name:ARRASCUE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1202 TROY SCHENECTADY RD
Mailing Address - Street 2:BUILDING 2
Mailing Address - City:LATHAM
Mailing Address - State:NY
Mailing Address - Zip Code:12110-1095
Mailing Address - Country:US
Mailing Address - Phone:518-220-9393
Mailing Address - Fax:518-220-9123
Practice Address - Street 1:1202 TROY SCHENECTADY RD
Practice Address - Street 2:BUILDING 2
Practice Address - City:LATHAM
Practice Address - State:NY
Practice Address - Zip Code:12110-1095
Practice Address - Country:US
Practice Address - Phone:518-220-9393
Practice Address - Fax:518-220-9123
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY124970207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00529593Medicaid
NY00529593Medicaid
NY33583GMedicare ID - Type Unspecified