Teodoro Mariano Jr MD PC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

129789 Issued in NY

Legal business name

TEODORO MARIANO JR MD PC

Practice address

21 Union Hill Dr
Spencerport, NY 14559-1965

Phone

(585) 352-4411

Fax

(585) 352-1305

NPI assigned

Sep 23, 2011

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Teodoro Reyes Mariano Jr., M.D.

Title

President

Phone

(585) 352-4411

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1316736000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1326412800000",
    "number": "1063795276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 UNION HILL DR",
            "city": "SPENCERPORT",
            "state": "NY",
            "postal_code": "145591965",
            "telephone_number": "585-352-4411",
            "fax_number": "585-352-1305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 UNION HILL DR",
            "city": "SPENCERPORT",
            "state": "NY",
            "postal_code": "145591965",
            "telephone_number": "585-352-4411",
            "fax_number": "585-352-1305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TEODORO MARIANO JR MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-23",
        "last_updated": "2012-01-13",
        "status": "A",
        "authorized_official_last_name": "MARIANO",
        "authorized_official_first_name": "TEODORO",
        "authorized_official_middle_name": "REYES",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "585-352-4411",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "129789",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00487921",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Karen Lynn Stein, RN
• Lee Ann Streicher, M.A. CCC-SLP/L
• Barbara Morse Swanson, RN, MSN, FNP
• Julie Katherine Swanson, REGISTERED NURSE
• Jeffrey Teibel, DPM
• The Foot Doctor
• The Unity Hospital of Rochester
• Karen Herman Thompson, LMT
• Karen Marie Titus
• Elena Lisa Torres, LPN

• Internal Medicine Physician in Spencerport, NY
• Providers in Spencerport, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.