Provider Demographics
NPI:1831800135
Name:MAROLI, MICHAEL ALFRED (PHARMD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:ALFRED
Last Name:MAROLI
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7155 STATE ROUTE 12
Mailing Address - Street 2:
Mailing Address - City:LOWVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:13367-2829
Mailing Address - Country:US
Mailing Address - Phone:315-376-4174
Mailing Address - Fax:315-376-4178
Practice Address - Street 1:7155 STATE ROUTE 12
Practice Address - Street 2:
Practice Address - City:LOWVILLE
Practice Address - State:NY
Practice Address - Zip Code:13367-2829
Practice Address - Country:US
Practice Address - Phone:315-376-4174
Practice Address - Fax:315-376-4178
Is Sole Proprietor?:No
Enumeration Date:2022-12-07
Last Update Date:2022-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY069881183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist