Active NPI
Wanda Teodorowicz-Marino, MD
- Ophthalmology Physician
- Yonkers, NY
National Provider Identifier
1255367678
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- 143436
- Practice address
- 2242 Central Park Ave
Yonkers, NY 10710-1457 - Phone
- (914) 793-7111
- Fax
- (914) 793-1325
- NPI assigned
- Jun 25, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | 143436 | NY | Primary |
Addresses
Primary practice location
2242 Central Park Ave
Yonkers, NY 10710-1457
Mailing address
2242 Central Park Ave
Yonkers, NY 10710-1457
Phone (914) 793-7111
Other identifiers 10
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 143436 | Other | NY | MEDICAL LICENCE |
| P1218912 | Other | OXFORD ID | |
| 00851501 | Medicaid | NY | |
| 0888912 | Other | AETNA HMO | |
| 143436A-40 | Other | 1199 | |
| 143436A-40 | Other | HEALTH FIRST 65 | |
| 18002947 | Other | NY | RAILROAD MEDICARE |
| 4412490 | Other | AETNA PPO | |
| 0091319 | Other | GHI | |
| 133295758 | Other | NY | TAX ID |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151193600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678147200000",
"number": "1255367678",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2242 CENTRAL PARK AVE",
"city": "YONKERS",
"state": "NY",
"postal_code": "107101457",
"telephone_number": "914-793-7111",
"fax_number": "914-793-1325"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2242 CENTRAL PARK AVE",
"city": "YONKERS",
"state": "NY",
"postal_code": "107101457",
"telephone_number": "914-793-7111",
"fax_number": "914-793-1325"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TEODOROWICZ-MARINO",
"first_name": "WANDA",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-06-25",
"last_updated": "2023-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "NY",
"license": "143436",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL LICENCE",
"identifier": "143436",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OXFORD ID",
"identifier": "P1218912",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00851501",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA HMO",
"identifier": "0888912",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "1199",
"identifier": "143436A-40",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH FIRST 65",
"identifier": "143436A-40",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "18002947",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA PPO",
"identifier": "4412490",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GHI",
"identifier": "0091319",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TAX ID",
"identifier": "133295758",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Yonkers, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.