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MARCELLUS FAMILY MEDICINE
NPI 1558791996
Non-Pharmacy Dispensing Site in Marcellus, NY

Active since November 21, 2013
28 E MAIN ST, MARCELLUS, NY 13108(315) 673-9926 Get Directions Write a Review

NPPES record last updated: November 21, 2013. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Marcellus Family Medicine NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MARCELLUS FAMILY MEDICINE (NPI 1558791996) is a healthcare organization registered as a non-pharmacy dispensing site in Marcellus, New York and active in the NPI registry since November 2013. The organization lists Kenny Heine, Vp Of Operations, as its authorized official.

NPPES Registry Identity

NPI1558791996
Entity TypeOrganization
Primary Taxonomy332900000X
Legal Business NameMARCELLUS FAMILY MEDICINE PLLC
Location Address28 E MAIN STMarcellus, NY 13108-1226
Mailing Address5626 Oberlin Dr, Suite 110San Diego, CA 92121-1705
Phone(315) 673-9926
Organization SubpartYesParent: Medvantx, Inc.
Authorized OfficialKenny HeineVp Of Operations · (858) 964-1506
Enumeration DateNovember 21, 2013
✔ NPI 1558791996 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNon-Pharmacy Dispensing SiteSuppliers
Taxonomy Code332900000X
License✔ Licensed in NY · 127430
Definition

A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.)

28 E MAIN ST, Marcellus, NY 13108
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Other Names 1

Doing Business AsMarcellus Family Medicine

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MARCELLUS FAMILY AND COSMETIC DENTISTRY, PC
Dentist (General Practice)
28 E MAIN ST
MARCELLUS, NY 13108
Onondaga County (315) 673-1131
PEDERSEN DENTAL SERVICES PC
Clinic/Center (Dental)
28 E MAIN ST
MARCELLUS, NY 13108
Onondaga County (315) 673-1131
REINA BAIZAN NP
Nurse Practitioner (Family)
28 E MAIN ST
MARCELLUS, NY 13108
Onondaga County (315) 673-9926

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Marcellus Family Medicine PLLC's NPI number?

The NPI number for Marcellus Family Medicine PLLC is 1558791996. It was assigned to this organization in the NPPES registry on November 21, 2013.

Where is Marcellus Family Medicine PLLC located?

Marcellus Family Medicine PLLC is located at 28 E Main St, Marcellus, NY 13108. The listed phone number is (315) 673-9926.

What is Marcellus Family Medicine PLLC's specialty?

The primary specialty registered for this NPI is Non-Pharmacy Dispensing Site with taxonomy code 332900000X.

When was this NPI record last updated?

The NPPES record for Marcellus Family Medicine PLLC was last updated on November 21, 2013. NPI Profile syncs with the weekly NPPES data releases published by CMS.