Provider Demographics
NPI:1306318324
Name:MARRIOTT, ANNE ROVAZZI
Entity type:Individual
Prefix:
First Name:ANNE
Middle Name:ROVAZZI
Last Name:MARRIOTT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 S RICHFIELD ST
Mailing Address - Street 2:
Mailing Address - City:MOHAWK
Mailing Address - State:NY
Mailing Address - Zip Code:13407-1219
Mailing Address - Country:US
Mailing Address - Phone:315-868-2076
Mailing Address - Fax:
Practice Address - Street 1:610 REESE RD
Practice Address - Street 2:
Practice Address - City:FRANKFORT
Practice Address - State:NY
Practice Address - Zip Code:13340-3404
Practice Address - Country:US
Practice Address - Phone:315-895-7491
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-02
Last Update Date:2019-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist