Individual
MR. JOSEPH F. MARRA JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNP
Contact information
Practice address
400 HARDING ST, CLAYTON, NM 88415-3339
(814) 943-6111
(914) 943-6118
Mailing address
400 HARDING ST, CLAYTON, NM 88415-3339
(814) 943-6111
(914) 943-6118
Taxonomy
Speciality
Code
Description
License number
State
261QU0200X
Urgent Care Clinic/Center
SP007906
PA
363LF0000X
Family Nurse Practitioner
Primary
CNP-01916
NM
363LF0000X
Family Nurse Practitioner
SP007906
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1015127860001
ACCESS
PA
01
—
1813844
HIGHMARK PPO
PA
05
—
200515230A
—
OK
05
—
50706756
—
NM
01
—
57-122813
UMWA
PA
01
—
57-1228130
VANTAGE PPO
PA
01
—
571228130
DEVON
PA
Enumeration date
03/28/2006
Last updated
01/28/2014
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