Active NPI
Mariel Gazmen Carino, MD
- General Practice Physician
- Olyphant, PA
National Provider Identifier
1760607204
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- License
- MD 033780 L
- Practice address
- 117 Susquehanna Ave
Olyphant, PA 18447 - Phone
- (570) 383-0275
- NPI assigned
- Apr 17, 2007
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | MD 033780 L | PA | Primary |
Addresses
Primary practice location
117 Susquehanna Ave
Olyphant, PA 18447
Mailing address
229 Medjay LN
Toms River, NJ 08755
Phone (732) 608-6203
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| E405 | Other | PA | GEISINGER HEALTH PLAN |
| 0005183329 | Other | TX | AETNA |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD 033780 L | PA | MD | General Practice Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176768000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1760607204",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "229 MEDJAY LN",
"city": "TOMS RIVER",
"state": "NJ",
"postal_code": "08755",
"telephone_number": "732-608-6203"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "117 SUSQUEHANNA AVE",
"city": "OLYPHANT",
"state": "PA",
"postal_code": "18447",
"telephone_number": "570-383-0275"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARINO",
"first_name": "MARIEL",
"middle_name": "GAZMEN",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-04-17",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "PA",
"license": "MD 033780 L",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GEISINGER HEALTH PLAN",
"identifier": "E405",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "0005183329",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Olyphant, PA
- Keith Brislin, COTA/L
- Jessica Marie Bullock, DPT
- Nastasha Elena Burdyn, L.M.T., N.C.T.M.B.
- Casey James Burke, D.O.
- Monica Cantrell, LPC, CRC
- Center for Orthotic & Prosthetic Care of Scranton, LLC
- Erin Kathleen Cherkauskas
- Chiropractic Center of Natural Health Care, P.C.
- Mara Cianfichi, M.S., CCC-SLP
- John Cimini, DMD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.