Provider Demographics
NPI:1144295312
Name:NOLAN, MARC ANTONY (MD)
Entity type:Individual
Prefix:DR
First Name:MARC
Middle Name:ANTONY
Last Name:NOLAN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:301 E 79TH ST APT 12J
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10075-0938
Mailing Address - Country:US
Mailing Address - Phone:212-400-9951
Mailing Address - Fax:212-737-7310
Practice Address - Street 1:420 E 55TH ST APT 1F
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-5140
Practice Address - Country:US
Practice Address - Phone:212-400-9951
Practice Address - Fax:212-737-7310
Is Sole Proprietor?:No
Enumeration Date:2006-02-21
Last Update Date:2025-04-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY213416207UN0901X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207UN0901XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01-0597943OtherTAX ID
NYG95404Medicare UPIN
451Q9J7021Medicare PIN