Healthcare Provider Details

I. General information

NPI: 1730578113
Provider Name (Legal Business Name): MARINO ACUPUNCTURE PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/22/2015
Last Update Date: 06/21/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

233 ALEXANDER ST
ROCHESTER NY
14607-2518
US

IV. Provider business mailing address

980 WESTFALL RD BLDG 200, STE 250
ROCHESTER NY
14618-2607
US

V. Phone/Fax

Practice location:
  • Phone: 585-857-3456
  • Fax: 585-454-4949
Mailing address:
  • Phone: 585-857-3456
  • Fax: 585-454-4949

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberX011569
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number004293
License Number StateNY

VIII. Authorized Official

Name: DR. DANIEL R MARINO
Title or Position: OWNER
Credential: DC, MS, LAC
Phone: 585-857-3456