| Doctor Name: | JOHN C MARINO |
| NPI Number: | 1023369295 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LMHC,CASAC |
| License Number: | 25796 |
| Business Practice Address: | 1111 Broadhollow Rd Farmingdale, NY - 117354820 |
| Business Phone Number: | 8004034360 |
| Business Fax Number: | |
| Mailing Address: | 1111 Broadhollow Rd, Suite 204 FARMINGDALE |
| State: | NY |
| Postal Code: | 117354820 |
| Phone Number: | 8004034360 |
| Fax Number: | |
| NPI Enumeration Date: | 09/27/2012 |
| NPI Last Update Date: | 10/16/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 25796 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NY |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |