Marzulla, Avery F

Marzulla, Avery F is an individual health care provider with primary practice located at 101 Dates Dr , Ithaca NY 14850-1342. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Allopathic & Osteopathic Physicians / Hospitalist. Allopathic & Osteopathic Physicians / Hospitalist is her primary health care specialty. Marzulla, Avery F can be contacted via phone (607) 274-4011.

Contact Information

Primary practice address
101 Dates Dr Ithaca NY 14850-1342
Phone: (607) 274-4011
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 23 015101 New York
Allopathic & Osteopathic Physicians / Hospitalist 208M00000X 015101 New York

Profile Details

NPI number 1639453988
LBN Legal business name Marzulla, Avery F
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 5th, 2011
Last updated Mar 17th, 2018 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1639453988 NPPES
New York MEDICAID 01995615

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