Individual
KATHLEEN A MAROLLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP
Contact information
Practice address
2211 GENESEE ST, SUITE 200, UTICA, NY 13501-5930
(315) 733-7598
(315) 733-7694
Mailing address
2211 GENESEE ST, UTICA, NY 13501-5930
(315) 733-7598
(315) 733-7598
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
F303266-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02179220
—
NY
Enumeration date
07/13/2005
Last updated
11/04/2010
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