Provider Demographics
NPI:1891911079
Name:VICTOR MARCHIONE, M.D.,L.L.C.
Entity Type:Organization
Organization Name:VICTOR MARCHIONE, M.D.,L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT/MGR
Authorized Official - Prefix:MRS
Authorized Official - First Name:PADDY
Authorized Official - Middle Name:
Authorized Official - Last Name:PERSAUD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-376-3092
Mailing Address - Street 1:600 PAVONIA AVE
Mailing Address - Street 2:5TH FLOOR
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07306-2929
Mailing Address - Country:US
Mailing Address - Phone:201-216-0744
Mailing Address - Fax:201-216-0844
Practice Address - Street 1:600 PAVONIA AVE
Practice Address - Street 2:5TH FLOOR
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07306-2929
Practice Address - Country:US
Practice Address - Phone:201-216-0744
Practice Address - Fax:201-216-0844
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-17
Last Update Date:2011-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA39172207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1265540959OtherPROVIDER NPI ID
NJ1746502Medicaid
NJ1746502Medicaid