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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 |
