Marc Maller, MD

Primary specialty

Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X

License

144029 Issued in NY

Practice address

700 E Brighton Avenue
Syracuse, NY 13205

Phone

(315) 413-3279

Fax

(315) 469-6558

NPI assigned

Sep 6, 2006

Last updated

Dec 6, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Elder Medical Services PC

  • Geriatric Medicine (Family Medicine) Physician
  • Cheektowaga, NY
  • NPI 1740388719
  NPD (past)
• St Josephs Medical PC

  • Family Medicine Physician
  • Liverpool, NY
  • NPI 1942501747
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1157500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196899200000",
    "number": "1134222144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 E BRIGHTON AVENUE",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "13205",
            "telephone_number": "315-413-3279",
            "fax_number": "315-469-6558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 E BRIGHTON AVENUE",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "13205",
            "telephone_number": "315-413-3279",
            "fax_number": "315-469-6558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALLER",
        "first_name": "MARC",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-06",
        "last_updated": "2007-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "NY",
            "license": "144029",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cynthia Rene Malek, LCSW-R, CASAC
• Jasmine Malhotra, MD
• Arooj Malik, MD
• Bilal Malik, MD
• Max Malikow, LMHC
• Nicholas Alan Mallette
• Marguerite H Mallia
• Nicole L Malliard, LMSW
• Grace Quinn Mallon
• Crystal Gayle Malloy

• Geriatric Medicine (Family Medicine) Physician in Syracuse, NY
• Providers in Syracuse, NY by specialty
• Geriatric Medicine (Family Medicine) Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.