Provider Demographics
NPI:1689618365
Name:MARINO, FLAVIA (MD, FAAP)
Entity Type:Individual
Prefix:DR
First Name:FLAVIA
Middle Name:
Last Name:MARINO
Suffix:
Gender:F
Credentials:MD, FAAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:155 EAST 38TH STREET
Mailing Address - Street 2:SUITE 2E
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016
Mailing Address - Country:US
Mailing Address - Phone:212-490-2446
Mailing Address - Fax:
Practice Address - Street 1:155 E 38TH ST
Practice Address - Street 2:SUITE 2E
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-2660
Practice Address - Country:US
Practice Address - Phone:212-490-2446
Practice Address - Fax:212-599-2376
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY141603208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYNP1163OtherOXFORD
NY26947POtherHIP PRIS #
NY0M0156OtherHEALTH NET
NY76A501OtherEMPIRE BLUE CROSS
NY0582911OtherAETNA HEALTH MGR, LLC
NY26947POtherHIP PRIS #