Provider Information for 1023369295
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JOHN C MARINO LMHC,CASAC
Sex: Male
NPI: 1023369295
Last Updated: 2012-10-16
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1023369295 | ||||||||||||
| Enumeration Date | 2012-09-27 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | NO | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 1111 BROADHOLLOW RD SUITE 204 FARMINGDALE, NY 11735-4820 United States Phone: 800-403-4360 | Fax: | ||||||||||||
| Primary Practice Address | 1111 BROADHOLLOW RD FARMINGDALE, NY 11735-4820 United States Phone: 800-403-4360 | Fax: | ||||||||||||
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