Doctor Name: | CHERYL MARINO |
NPI Number: | 1063416428 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 332239-1 |
Business Practice Address: | 45 Hudson Ave Glens Falls, NY - 128014313 |
Business Phone Number: | 5187934477 |
Business Fax Number: | |
Mailing Address: | 45 Hudson Ave, Po Box 144 GLENS FALLS |
State: | NY |
Postal Code: | 128014313 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 06/13/2005 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LX0001X |
License Number: | 332239-1 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Obstetrics & Gynecology |
Taxonomy Definition: |