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Michael A Marino

Physical Therapist

Respiratory, Developmental, Rehabilitative and Restorative Service Providers

4079 Richmond Ave, Staten Island, NY 10312-5633

PECOS Enrollment

Based on the most recent information from CMS, provider Michael A Marino does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 34 days ago.

Profile Details

Provider ID
1912010638
Provider Type
Individual
Full Name
Marino, Michael A
Title
Mr.
Credential
PT

Gender
Male
Sole Proprietor
Yes
Enumeration Date
8/16/2006
Last Updated
10/24/2008

Contact Information

Practice Location

4079 Richmond Ave, Staten Island, NY 10312-5633

(718) 984-8400

(718) 984-8419

Mailing Location

4079 Richmond Ave, Staten Island, NY 10312-5633

(718) 984-8400

(718) 984-8419

Provider Taxonomies

Code	Description	License
Code 225100000X Primary	Description Physical Therapist Respiratory, Developmental, Rehabilitative and Restorative Service Providers	License 7507 New York

Provider Identifiers

ID	Description	Issuer
ID 0098027	Description Other	Issuer GHI PROVIDER NUMBER New York
ID P468625	Description Other	Issuer OXFORD PROVIDER NUMBER New York

Michael A Marino

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

ID

Description

Issuer

Lizaso, Arthur

Fedosseev, Vladimir

Hanafy, Hajar Sherif

Labbate, Daniela

Martinez, Judy Gatpo

Maximous Pt Pllc

Cruz, Jose L

Holtzer Physical Therapy Pllc

Guirges, Zarif

Hubner, Doris A