Jean Mary Robert Marius

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

054456 Issued in NY

Practice address

231 Wade Road Ext
Suite 101
Latham, NY 12110

Phone

(518) 782-1900

Fax

(518) 782-1318

NPI assigned

Aug 6, 2009

Last updated

Aug 6, 2009By 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

Enrolled in FL

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Networks

• Freedom Health HMO Network

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

{
    "created_epoch": "1249516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1249516800000",
    "number": "1295966380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3189",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132203189",
            "telephone_number": "315-454-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "231 WADE ROAD EXT",
            "address_2": "SUITE 101",
            "city": "LATHAM",
            "state": "NY",
            "postal_code": "12110",
            "telephone_number": "518-782-1900",
            "fax_number": "518-782-1318"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARIUS",
        "first_name": "JEAN MARY",
        "middle_name": "ROBERT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-08-06",
        "last_updated": "2009-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "054456",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Caitlin Maloy
• Mane Solution
• Matthew R. Manell, MS INTERN
• Caroline Mannion
• Mackenzie Rae Marino, MS, BCBA, LBA-NY
• Marjorie Russell NP in Psychiatry, PLLC
• Martin Joseph Marrazo, PH.D.
• Judy Ann Marshall
• Kathleen M Marshall, NP
• Korey Marshall, NP

• General Practice Dentistry in Latham, NY
• Providers in Latham, NY by specialty
• General Practice Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2009; 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.