Provider Demographics
NPI:1700895638
Name:PIETROPAOLI, MARC P (MD)
Entity Type:Individual
Prefix:DR
First Name:MARC
Middle Name:P
Last Name:PIETROPAOLI
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:791 W GENESEE STREET RD
Mailing Address - Street 2:
Mailing Address - City:SKANEATELES
Mailing Address - State:NY
Mailing Address - Zip Code:13152-9377
Mailing Address - Country:US
Mailing Address - Phone:315-685-7544
Mailing Address - Fax:315-685-7549
Practice Address - Street 1:791 W GENESEE STREET RD
Practice Address - Street 2:
Practice Address - City:SKANEATELES
Practice Address - State:NY
Practice Address - Zip Code:13152-9377
Practice Address - Country:US
Practice Address - Phone:315-685-7544
Practice Address - Fax:315-685-7549
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-07
Last Update Date:2021-03-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY206556207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYG61017Medicare UPIN
1248090001Medicare NSC