Provider Demographics
NPI:1376116533
Name:MAURINO, JAMES PAUL
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:PAUL
Last Name:MAURINO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4338 CLARK ST
Mailing Address - Street 2:
Mailing Address - City:HAMBURG
Mailing Address - State:NY
Mailing Address - Zip Code:14075-3827
Mailing Address - Country:US
Mailing Address - Phone:716-472-8329
Mailing Address - Fax:
Practice Address - Street 1:4338 CLARK ST
Practice Address - Street 2:
Practice Address - City:HAMBURG
Practice Address - State:NY
Practice Address - Zip Code:14075-3827
Practice Address - Country:US
Practice Address - Phone:716-472-8329
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-23
Last Update Date:2025-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY025342103TC1900X
NY053146-1104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
No104100000XBehavioral Health & Social Service ProvidersSocial Worker