Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 141055 | NY |
N | 208600000X | Surgeon | 141055 | NY |
Y | 2086S0102X | Surgical Critical Care | 141055 | NY |
N | 2086S0127X | Trauma Surgeon | 141055 | NY |
NPI | 1275604365 |
---|---|
Provider Name | Corrado P Marini |
First Address | Mineola, NY 11501-2528 |
Second Address | Mineola, NY 11501-2528 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/11/2006 |
Last Update Date | 15/12/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00812419 | (05) | NY |