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Dr. Marcarious A Mariyampillai

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NPI Number Detailed Information

Provider Information:

Name: Dr. Marcarious A Mariyampillai
Gender: M
Provider License Number If Given: 25MA06542600

NPI Information:

NPI: 1790770279
Entity Type
(Individual or Organization):
1-ind
Enumeration Date: 9/12/2005

Last Update Date: 6/23/2008

Provider Business Mailing Address:

Address: 825 BLOOMFIELD AVE SUITE LL-1
Verona, NJ 07044
Phone Number: 9732393770
Fax Number: 9732393774

Provider Business Practice Location Address:

Address: 825 BLOOMFIELD AVE SUITE LL-1
Verona, NJ 07044
Phone Number: 9732393770
Fax Number: 9732393774

Provider Taxonomy:

Primary: 207R00000X
Secondary (if any):
State: NJ