Individual
MARK MARCELLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4498 MAIN/HARLEM RD SUITE 24, AMHERST, NY 14226
(716) 839-1550
(716) 839-1696
Mailing address
4498 MAIN/HARLEM RD SUITE 24, AMHERST, NY 14226
(716) 839-1550
(716) 839-1696
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
011840-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
J100132514
PT
NY
Enumeration date
04/24/2019
Last updated
04/24/2019
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