Provider Demographics
NPI:1245383405
Name:MARIANI, JOHN J (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:J
Last Name:MARIANI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:51 E 25TH ST STE 7E
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10010-2945
Mailing Address - Country:US
Mailing Address - Phone:646-609-6771
Mailing Address - Fax:646-588-1984
Practice Address - Street 1:51 E 25TH ST STE 7E
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010-2945
Practice Address - Country:US
Practice Address - Phone:646-609-6771
Practice Address - Fax:646-588-1984
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-19
Last Update Date:2020-02-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY1990482084A0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084A0401XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYH95199Medicare UPIN