Provider Demographics
NPI:1861787699
Name:MARIENBERG, WILLIAM H (DVM)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:H
Last Name:MARIENBERG
Suffix:
Gender:M
Credentials:DVM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3004 LURTING AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10469-4018
Mailing Address - Country:US
Mailing Address - Phone:718-881-1000
Mailing Address - Fax:718-881-1100
Practice Address - Street 1:3004 LURTING AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10469-4018
Practice Address - Country:US
Practice Address - Phone:718-881-1000
Practice Address - Fax:718-881-1100
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-09
Last Update Date:2011-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004398-1174M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174M00000XOther Service ProvidersVeterinarian