Individual
DR. MARK VARALLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
670 DAVISON RD, LOCKPORT, NY 14094-5338
(716) 438-0822
(716) 438-0822
Mailing address
PO BOX 1207, WILSON, NY 14172-1207
(716) 438-0822
(716) 438-0822
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
199547
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00020919101
UNIVERA
NY
01
—
000523692001
BLUE CROSS./ BLUE SHIELD
NY
05
—
01564007
—
NY
01
—
1590239
INDEPENDENT HEALTH
NY
01
—
3103079002
GHI
NY
Enumeration date
02/20/2006
Last updated
02/24/2015
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