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NPI 1275604365

NPI 1275604365 : CORRADO P MARINI MD : MINEOLA, NY

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General NPI Number Information
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    NPI Number           |    1275604365
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    Entity Type          |    Individual 
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    Provider Name        |    CORRADO P MARINI MD
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    11/13/2006
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    Last Update Date     |    12/15/2016
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Provider Practice Location Address
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    Address Line         |    173 MINEOLA BLVD SUITE 401
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    City                 |    MINEOLA
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    State                |    NY
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    Zip                  |    11501-2528
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    Country              |    US
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    Telephone            |    516-663-1145
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    Fax                  |    516-877-2440
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Provider Business Mailing Address
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    Address Line         |    173 MINEOLA BLVD SUITE 401
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    City                 |    MINEOLA
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    State                |    NY
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    Zip                  |    11501-2528
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    Country              |    US
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    Telephone            |    516-663-1145
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    Fax                  |    516-877-2440
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    208600000X
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    Taxonomy Name        |    Surgery Physician
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    License Number       |    141055
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    License Number State |    NY
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Taxonomy #2
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    Taxonomy Code        |    2086S0102X
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    Taxonomy Name        |    Surgical Critical Care Physician
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    License Number       |    141055
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    License Number State |    NY
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Taxonomy #3
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    Taxonomy Code        |    2086S0127X
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    Taxonomy Name        |    Trauma Surgery Physician
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    License Number       |    141055
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    License Number State |    NY
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