Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MARLON PEMBERTON
Active Sole ProprietorMedical Technologist · NORMAL, IL
Registration Details
- NPI Number
- 1942746185
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jan 11, 2017 (9.2785751161337 yrs)
- Last Updated
- Jan 11, 2017
- License
-
246ZE0600X (NY)
- Sole Proprietor
- Yes
Practice Information
- Address
-
1604 VISA DR STE 1NORMAL, IL, 617612195Browse IL providers · Browse ZIP 61761
- Phone
- 3094541100
- Fax
- 3094541107
- Primary Specialty
-
Medical Technologist
246QM0706X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.