Provider Demographics
NPI:1811974140
Name:SARNOW, MARC R (DPM)
Entity type:Individual
Prefix:DR
First Name:MARC
Middle Name:R
Last Name:SARNOW
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:79 HAMMOND LN STE 9
Mailing Address - Street 2:
Mailing Address - City:PLATTSBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12901-2008
Mailing Address - Country:US
Mailing Address - Phone:518-563-0570
Mailing Address - Fax:518-324-5406
Practice Address - Street 1:79 HAMMOND LN STE 9
Practice Address - Street 2:
Practice Address - City:PLATTSBURGH
Practice Address - State:NY
Practice Address - Zip Code:12901-2008
Practice Address - Country:US
Practice Address - Phone:518-563-0570
Practice Address - Fax:518-324-5406
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-28
Last Update Date:2023-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT0560000158213E00000X
NYN0046801213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY54274 BMedicare ID - Type Unspecified
U42283Medicare UPIN
VTVN1008Medicare ID - Type Unspecified