| Doctor Name: | THET THET MAR |
| NPI Number: | 1043563232 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | NP |
| License Number: | F337438-1 |
| Business Practice Address: | 120 Hobart St Utica, NY - 135014308 |
| Business Phone Number: | 3157981149 |
| Business Fax Number: | 3157343565 |
| Mailing Address: | 120 Hobart St, UTICA |
| State: | NY |
| Postal Code: | 135014308 |
| Phone Number: | 3157981149 |
| Fax Number: | 3157343565 |
| NPI Enumeration Date: | 10/25/2012 |
| NPI Last Update Date: | 06/24/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | F337438-1 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |