Provider Demographics
NPI:1144361312
Name:MARMORALE, MARTIN CHARLES (DC)
Entity type:Individual
Prefix:DR
First Name:MARTIN
Middle Name:CHARLES
Last Name:MARMORALE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2307 BELLMORE AVE UNIT A
Mailing Address - Street 2:
Mailing Address - City:BELLMORE
Mailing Address - State:NY
Mailing Address - Zip Code:11710-5651
Mailing Address - Country:US
Mailing Address - Phone:516-679-2225
Mailing Address - Fax:516-977-1319
Practice Address - Street 1:2307 BELLMORE AVE UNIT A
Practice Address - Street 2:
Practice Address - City:BELLMORE
Practice Address - State:NY
Practice Address - Zip Code:11710-5651
Practice Address - Country:US
Practice Address - Phone:516-679-2225
Practice Address - Fax:516-977-1319
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-09
Last Update Date:2009-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX004607-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor