Provider Demographics
NPI:1871638452
Name:MARRONE, ERNEST RICHARD SR (DC)
Entity Type:Individual
Prefix:DR
First Name:ERNEST
Middle Name:RICHARD
Last Name:MARRONE
Suffix:SR
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:70 DEARFIELD DRIVE
Mailing Address - Street 2:
Mailing Address - City:GREENWICH
Mailing Address - State:CT
Mailing Address - Zip Code:06831-5350
Mailing Address - Country:US
Mailing Address - Phone:203-661-4445
Mailing Address - Fax:203-661-4445
Practice Address - Street 1:70 DEARFIELD DR
Practice Address - Street 2:
Practice Address - City:GREENWICH
Practice Address - State:CT
Practice Address - Zip Code:06831-5350
Practice Address - Country:US
Practice Address - Phone:203-661-4445
Practice Address - Fax:203-661-4445
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000085111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
EHX04121Medicare UPIN