Provider Demographics
NPI:1952395584
Name:AUSLENDER, MARCELO (MD)
Entity Type:Individual
Prefix:
First Name:MARCELO
Middle Name:
Last Name:AUSLENDER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 HAWKINS DR
Mailing Address - Street 2:DEPARTMENT OF PEDIATRICS
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52242-1009
Mailing Address - Country:US
Mailing Address - Phone:319-467-5042
Mailing Address - Fax:319-356-8443
Practice Address - Street 1:200 HAWKINS DR
Practice Address - Street 2:DEPARTMENT OF PEDIATRICS
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52242-1009
Practice Address - Country:US
Practice Address - Phone:319-467-5042
Practice Address - Fax:319-356-8443
Is Sole Proprietor?:No
Enumeration Date:2005-09-09
Last Update Date:2015-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2048382080P0202X
OH35-0629502080P0202X
IAMD-429802080P0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0058515Medicaid
NY01712587Medicaid
OH0058515Medicaid
OHH056160Medicare PIN
OH0058515Medicaid