Individual
DR. MARVIN MAISONAVE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7571 STATE ROUTE 54, BATH, NY 14810-9504
(315) 589-9657
(315) 589-9406
Mailing address
3388 RIDGE RD, WILLIAMSON, NY 14589-9352
(315) 589-9657
(315) 589-9406
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
160089-1
NY
Other
Enumeration date
07/16/2007
Last updated
07/16/2007
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