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NPI Code Detail

MEDICARE: CYNTHIA M MARINO PA

MEDICARE: CYNTHIA M MARINO PA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1364SP0808XPsychiatric/Mental Health Clinical Nurse Specialist002173NY
2363AM0700XMedical Physician Assistant002173NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10107647OTHERNYINDEPENDENT HEALTH
2000570164004OTHERNYCOMMUNITY BLUE

General Provider Information

NPI Number : 1982683934
Entity Type Code : Individual
Provider Name (Legal Business Name) : CYNTHIA M MARINO PA
Provider Business Mailing Address
First Line : 3200 WEST ST
Second Line :
City : CANANDAIGUA
State : NY
Zip : 14424-1722
Country : US
Telephone Number : 585-905-0061
Fax Number : 585-412-6612
Provider Business Practice Location Address
First Line : 3200 WEST ST
Second Line :
City : CANANDAIGUA
State : NY
Zip : 14424-1722
Country : US
Telephone Number : 585-905-0061
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/10/2006
Last Update Date : 01/10/2020

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Directions to “ CYNTHIA M MARINO PA” Practice Location

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