Neal F Marshall, Optometrist, PLLC
Organization Active NPI Optometrist · De Witt, NY
NPI 1235317645 · NPPES record last updated Oct 23, 2013
Key facts
- NPI
- 1235317645
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Optometrist 152W00000X
- License
- TUV004851-1 (NY)
- Legal business name
- NEAL F MARSHALL, OPTOMETRIST, PLLC
- Practice address
- 4473 E Genesee St
De Witt, NY 13214-2242 - Phone
- (315) 446-1210
- NPI assigned
- Feb 7, 2008
- Organization subpart
- No
Authorized official
- Name
- Neal F Marshall, OD
- Title
- Owner
- Phone
- (315) 446-1210
Practitioners 1
-
Neal Marshall, OD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20080825000566 | NY | Part B Supplier - Clinic/Group Practice | 6204901390 |
Receives reassigned benefits from 1 practitioner Practice locations: East Syracuse, NY |
National Provider Directory
Locations
5775 Bridge St
Ste C
East Syracuse, NY 13057
Phone (315) 446-1210
4473 E Genesee St
Syracuse, NY 13214
Phone (315) 446-1210
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist |
152W00000X | TUV004851-1 | NY | Yes |
Addresses
Primary practice location
4473 E Genesee St
De Witt, NY 13214-2242
Mailing address
4473 E Genesee St
De Witt, NY 13214-2242
Phone (315) 446-1210
Other names
- Kavanagh & Marshall
Other providers in De Witt, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 23, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.