Active NPI
Martin Joseph Marrazo, PH.D.
- Clinical Psychologist
- Latham, NY
National Provider Identifier
1497796882
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 4777-1
- Practice address
- 713 Troy Schenectady Rd
Suite 224
Latham, NY 12110-2490 - Phone
- (518) 785-3614
- Fax
- (518) 785-3615
- NPI assigned
- Jun 9, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 4777-1 | NY | Primary |
Addresses
Primary practice location
713 Troy Schenectady Rd
Suite 224
Latham, NY 12110-2490
Mailing address
713 Troy Schenectady Rd
Suite 224
Latham, NY 12110-2490
Phone (518) 785-3614
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4777-1 | NY | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149811200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1216339200000",
"number": "1497796882",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "713 TROY SCHENECTADY RD",
"address_2": "SUITE 224",
"city": "LATHAM",
"state": "NY",
"postal_code": "121102490",
"telephone_number": "518-785-3614",
"fax_number": "518-785-3615"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "713 TROY SCHENECTADY RD",
"address_2": "SUITE 224",
"city": "LATHAM",
"state": "NY",
"postal_code": "121102490",
"telephone_number": "518-785-3614",
"fax_number": "518-785-3615"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARRAZO",
"first_name": "MARTIN",
"middle_name": "JOSEPH",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-09",
"last_updated": "2008-07-18",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NY",
"license": "4777-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Latham, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.