Marina I Peredo MD PC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

190716 Issued in NY

Legal business name

MARINA I PEREDO MD PC

Practice address

260 Middle Country Rd
Ste 208
Smithtown, NY 11787

Phone

(631) 863-3223

Fax

(631) 863-3334

NPI assigned

Mar 8, 2006

Last updated

Jul 10, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Marina I Peredo, MD PC

Title

Owner President

Phone

(631) 863-3221

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1141776000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215648000000",
    "number": "1427026392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "260 MIDDLE COUNTRY RD",
            "address_2": "STE 208",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "11787",
            "telephone_number": "631-863-3223",
            "fax_number": "631-863-3334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "260 MIDDLE COUNTRY RD",
            "address_2": "STE 208",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "11787",
            "telephone_number": "631-863-3223",
            "fax_number": "631-863-3334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARINA I PEREDO MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-08",
        "last_updated": "2008-07-10",
        "status": "A",
        "authorized_official_last_name": "PEREDO",
        "authorized_official_first_name": "MARINA",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "OWNER PRESIDENT",
        "authorized_official_telephone_number": "631-863-3221",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MD PC"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NY",
            "license": "190716",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01836915",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• David M Margulies, M.D.
• Jillian Margulies, NP
• Marin Medical Services, PLLC
• Edgar L. Marin, M.D.
• Morisa J Marin, M.D.
• Sarah Marine, FNP-C
• Luiziana Manuela Marinescu, M.D.
• Marjorie C. Ravitz DPM PC
• Mark J. Zuckerman, Physician, P.C.
• Mark Jan Sterling MD PC

• Dermatology Physician in Smithtown, NY
• Providers in Smithtown, NY by specialty
• Dermatology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2008; 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.