Provider Demographics
NPI:1780899138
Name:MARINO, CATHERINE T (MD)
Entity type:Individual
Prefix:DR
First Name:CATHERINE
Middle Name:T
Last Name:MARINO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43 KNAPP ROAD
Mailing Address - Street 2:
Mailing Address - City:POUND RIDGE
Mailing Address - State:NY
Mailing Address - Zip Code:10576
Mailing Address - Country:US
Mailing Address - Phone:516-316-7316
Mailing Address - Fax:
Practice Address - Street 1:43 KNAPP RD
Practice Address - Street 2:
Practice Address - City:POUND RIDGE
Practice Address - State:NY
Practice Address - Zip Code:10576
Practice Address - Country:US
Practice Address - Phone:516-316-7316
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-11
Last Update Date:2023-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY120390207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYC67072Medicare UPIN
NY317681Medicare ID - Type Unspecified