Provider Demographics
NPI:1215903562
Name:MARQUARDT, JOHN D (MD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:D
Last Name:MARQUARDT
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:125 LATTIMORE RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14620-4159
Mailing Address - Country:US
Mailing Address - Phone:585-473-1033
Mailing Address - Fax:585-473-8605
Practice Address - Street 1:125 LATTIMORE RD
Practice Address - Street 2:SUITE 100
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14620-4159
Practice Address - Country:US
Practice Address - Phone:585-473-1033
Practice Address - Fax:585-473-8605
Is Sole Proprietor?:No
Enumeration Date:2006-02-27
Last Update Date:2009-12-08
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Provider Licenses
StateLicense IDTaxonomies
NY131494-1207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP101131494OtherCROSSBRIDGE PHYSICIANS
NY200041061OtherMEDICARE RAILROAD
NM102282OtherPREFERRED CARE
NYRC60131494OtherRCIPA, INC.
NY5010331OtherAETNA
NY00609590Medicaid
NYP010131494OtherEXCELLUS BC BS
NY00609590Medicaid
NYP101131494OtherCROSSBRIDGE PHYSICIANS