Provider Demographics
NPI:1114948577
Name:CASTRO-MAGANA, MARIANO SALVADOR (MD)
Entity Type:Individual
Prefix:
First Name:MARIANO
Middle Name:SALVADOR
Last Name:CASTRO-MAGANA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:222 STATION PLZ N
Mailing Address - Street 2:SUITE 611
Mailing Address - City:MINEOLA
Mailing Address - State:NY
Mailing Address - Zip Code:11501-3808
Mailing Address - Country:US
Mailing Address - Phone:516-663-2532
Mailing Address - Fax:516-663-2233
Practice Address - Street 1:120 MINEOLA BLVD
Practice Address - Street 2:SUITE 210
Practice Address - City:MINEOLA
Practice Address - State:NY
Practice Address - Zip Code:11501-4073
Practice Address - Country:US
Practice Address - Phone:516-663-3090
Practice Address - Fax:516-663-3070
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2021-03-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY1492622080P0205X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0205XAllopathic & Osteopathic PhysiciansPediatricsPediatric Endocrinology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01240344Medicaid
NYB19315Medicare UPIN