Doctor Name: | DR. JOHN C MARLOW |
NPI Number: | 1720344187 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | 040400 |
Business Practice Address: | 172 East Ave Center For Optimum Health New Canaan, CT - 068405615 |
Business Phone Number: | 2032477821 |
Business Fax Number: | |
Mailing Address: | 172 East Ave, Center For Optimum Health NEW CANAAN |
State: | CT |
Postal Code: | 068405615 |
Phone Number: | 2039720402 |
Fax Number: | 2039720410 |
NPI Enumeration Date: | 04/10/2012 |
NPI Last Update Date: | 04/10/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 040400 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CT |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |