Provider Demographics
NPI:1831105899
Name:MARINO, JOHN C (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:C
Last Name:MARINO
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Gender:M
Credentials:MD
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Mailing Address - Street 1:2 COULTER ROAD
Mailing Address - Street 2:CLIFTON SPRINGS HOSP & CLINIC ATTN MEDICAL STAFF OFFICE
Mailing Address - City:CLIFTON SPRINGS
Mailing Address - State:NY
Mailing Address - Zip Code:14432
Mailing Address - Country:US
Mailing Address - Phone:315-462-1464
Mailing Address - Fax:315-462-2487
Practice Address - Street 1:2 COULTER ROAD
Practice Address - Street 2:BEHAVIORAL HEALTH
Practice Address - City:CLIFTON SPRINGS
Practice Address - State:NY
Practice Address - Zip Code:14432
Practice Address - Country:US
Practice Address - Phone:315-462-1465
Practice Address - Fax:315-462-0145
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
NY1763162084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry