Provider Demographics
NPI:1720077076
Name:MARROW, GREGORY JAMES (OD)
Entity Type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:JAMES
Last Name:MARROW
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 826
Mailing Address - Street 2:
Mailing Address - City:NORTH HAMPTON
Mailing Address - State:NH
Mailing Address - Zip Code:03862-0826
Mailing Address - Country:US
Mailing Address - Phone:603-781-0427
Mailing Address - Fax:
Practice Address - Street 1:44 LAFAYETTE RD UNIT 4
Practice Address - Street 2:
Practice Address - City:NORTH HAMPTON
Practice Address - State:NH
Practice Address - Zip Code:03862-7000
Practice Address - Country:US
Practice Address - Phone:603-781-0427
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-19
Last Update Date:2017-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0618001016152W00000X
NH922152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA4670630001Medicare NSC
VA141040OtherBCBS
VAU82159Medicare UPIN
VA175496OtherSOUTHERN HEALTH
VA410001286Medicare ID - Type Unspecified