Doctor Name: | DR. MICHAEL F. MARINO |
NPI Number: | 1215030093 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PH.D. |
License Number: | 008329 |
Business Practice Address: | 1305 Middle Country Rd Suite 7 Selden, NY - 117842554 |
Business Phone Number: | 6312209285 |
Business Fax Number: | |
Mailing Address: | 1305 Middle Country Rd, Suite 7 SELDEN |
State: | NY |
Postal Code: | 117842554 |
Phone Number: | 6312209285 |
Fax Number: | |
NPI Enumeration Date: | 09/06/2006 |
NPI Last Update Date: | 07/16/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | 008329 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |