National Provider Identifier
Marvin Maisonave, MD
Marvin Maisonave, MD is listed in the NPPES registry with a primary specialty of Emergency Medicine Physician in Bath, NY and a listed phone number of (315) 589-9657.
Profile Overview
- NPI
- 1801095294
- Provider Type
- Individual
- Primary Specialty
- Emergency Medicine Physician
- Enumeration Date
- July 16, 2007
- Last Updated
- July 16, 2007
Practice Location
- 7571 State Route 54
- Bath, NY 14810-9504
Phone: (315) 589-9657
Mailing Address
- 3388 Ridge RD
- Williamson, NY 14589-9352
Specialties
- Emergency Medicine Physician (207P00000X)
Full Record
- NPI
- 1801095294
- Entity Type
- Individual
- Last Name
- Maisonave
- First Name
- Marvin
- Name Prefix
- Dr.
- Credential
- MD
- Mailing Street Address
- 3388 Ridge RD
- Mailing City
- Williamson
- Mailing State
- NY
- Mailing ZIP Code
- 14589-9352
- Mailing Country
- US
- Mailing Phone
- (315) 589-9657
- Mailing Fax
- (315) 589-9406
- Practice Street Address
- 7571 State Route 54
- Practice City
- Bath
- Practice State
- NY
- Practice ZIP Code
- 14810-9504
- Practice Country
- US
- Practice Phone
- (315) 589-9657
- Practice Fax
- (315) 589-9406
- Enumeration Date
- July 16, 2007
- Last Updated
- July 16, 2007
- Sex
- Male
- Sole Proprietor
- No
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Emergency Medicine Physician (207P00000X)