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Individual
DR. NICHOLAS PAUL MARCONI
Active
Individual
DR. NICHOLAS PAUL MARCONI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
030-0000260
VT
152WC0802X
Corneal and Contact Management Optometrist
Primary
030-0000260
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
030-0000260
LICENSE NUMBER
VT
01
—
502217
ARBO OE NUMBER
VT
01
—
VT0260
EYEMED PROVIDER ID NUMBER
VT
Enumeration date
02/25/2007
Last updated
11/29/2011
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